Factors influencing acupuncture regimen completion by breast cancer patients: real-world data from an NCI-designated comprehensive cancer center.

BACKGROUND: Acupuncture is a complementary medicine therapy increasingly used to manage cancer-related symptoms. Despite its demonstrated efficacy, adherence rates among patients with breast cancer remain suboptimal. This study aimed to identify factors associated with non-completion of acupuncture regimens within a single institutional integrative oncology program to identify modifiable barriers to service utilization. METHODS: Patients with breast cancer who began acupuncture treatment at an NCI-designated comprehensive cancer center between May 2022 and March 2025 were retrospectively included in this study. Regimen completion was defined as attending a minimum of eight sessions. Demographic, clinical, and patient-reported outcomes (PROMIS-29) were analyzed. Stepwise multivariable logistic regression was used to identify predictors of regimen completion. RESULTS: Of 563 patients, 268 (47.6%) completed the recommended acupuncture regimen. In multivariable analysis, non-White race (OR 0.64, 95% CI 0.45-0.92, p = 0.016), advanced cancer stage (defined as stages 3-4; OR 0.55, 95% CI 0.37-0.82, p = 0.003), smoking history (OR 0.63, 95% CI 0.41-0.95, p = 0.029), and moderate-to-severe anxiety (OR 0.67, 95% CI 0.45-1.00, p = 0.048) were independently associated with lower odds of regimen completion. CONCLUSION: Racial disparities, clinical stage, baseline anxiety, and smoking history were significantly associated with lowered acupuncture adherence in patients with breast cancer. Tailored interventions including early identification of at-risk patients and integrated mental health support may be evaluated to improve adherence to integrative therapies.