{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:06:48Z","timestamp":1769040408590,"version":"3.49.0"},"reference-count":28,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FCT - Foundation for Science and Technology","award":["UID\/04045"],"award-info":[{"award-number":["UID\/04045"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Endocrine therapy (ET) is a common treatment for hormone-dependent breast cancer and is associated with a significant reduction in recurrence and mortality rates. However, the decision to initiate endocrine therapy is a critical and often distressing juncture for patients. The need to weigh its survival benefits against the potential burden of side effects, including mood changes, pain, muscle stiffness, and fatigue, can render this decision-making phase a source of significant distress. The present systematic review aimed to identify and synthesize the sociodemographic and psychosocial predictors of the decision-making process related to ET adherence among women with breast cancer. Methods: A systematic literature search was conducted in three electronic databases\u2014PubMed Central, ProQuest, and Scopus\u2014to identify studies examining the association between sociodemographic and psychosocial factors and the decision-making process regarding ET among women with breast cancer. Inclusion criteria encompassed cross-sectional studies published between 2000 and 2025. Data were extracted and analyzed to identify recurring predictors across studies. The findings were synthesized through a narrative synthesis. Results: Twelve cross-sectional studies met the inclusion criteria, comprising a total of 8510 women diagnosed with breast cancer and undergoing ET. Ten studies (83%) identified sociodemographic variables\u2014such as age, marital status, educational level, and ethnicity\u2014as significant predictors of decision-making. Moreover, nine studies (75%) reported psychosocial factors, including quality of life (QoL), fear of progression, infertility concerns, and social support, as influential in the decision to initiate or continue ET. Specifically, the decision to adhere to ET is generally supported by younger age, higher education, better perceived quality of life, and greater social support. Conversely, it is hindered by lower income, lower education, fertility concerns related to marital status, and diminished quality of life. Conclusions: The findings of this review indicate that both sociodemographic and psychosocial factors play key roles in shaping women\u2019s decisions regarding adherence to ET. Understanding these predictors can facilitate decision-making and inform the development of targeted interventions aimed at improving treatment adherence and supporting patient-centered care in breast cancer treatment. The focus on decision-making processes, rather than on adherence rates, is what distinguishes this review from other systematic reviews.<\/jats:p>","DOI":"10.3390\/jcm15020858","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T08:48:08Z","timestamp":1768985288000},"page":"858","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Decision-Making Regarding Endocrine Therapy in Breast Cancer Survivors: A Systematic Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Beatriz","family":"Mesquita","sequence":"first","affiliation":[{"name":"Department of Education and Psychology, University of Tr\u00e1s-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0817-0157","authenticated-orcid":false,"given":"Ana","family":"B\u00e1rtolo","sequence":"additional","affiliation":[{"name":"CINTESIS.UPT@RISE-Health, Portucalense University, 4200-072 Porto, Portugal"}]},{"given":"S\u00f3nia","family":"Remondes-Costa","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Department of Education and Psychology, University of Tr\u00e1s-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4083-200X","authenticated-orcid":false,"given":"Joana","family":"Carreiro","sequence":"additional","affiliation":[{"name":"Department of Social Sciences and Behavior, University of Maia, 4475-690 Maia, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5296-0930","authenticated-orcid":false,"given":"Susana","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), Department of Education and Psychology, University of Tr\u00e1s-os-Montes e Alto Douro, 5000-801 Vila Real, Portugal"},{"name":"Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref_1","unstructured":"Ferlay, J., Ervik, M., Lam, F., Laversanne, M., Colombet, M., Mery, L., Pi\u00f1eros, M., Znaor, A., Soerjomataram, I., and Bray, F. 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Drug Saf."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/858\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T09:08:52Z","timestamp":1768986532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":28,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020858"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020858","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]}}}