Background
Breast cancer is the most common malignancy in women and also shares similar risk factors with fatty liver, especially metabolic associated fatty liver disease (MAFLD). Chemotherapy can lead to hepatic impairment and hepatic steatosis (HS), which seriously affects the treatment and quality of life of breast cancer women (BCW). Therefore, this study aims to investigate the incidences of HS and MAFLD based on liver ultrasound elastography (USE), liver function abnormalities, and metabolic syndrome in Chinese BCW in the initially diagnosed, during chemotherapy and follow-up stages.
Methods
A total of 767 BCW treated at Chongqing Breast Cancer Centre were finally enrolled and classified into initially diagnosed group, chemotherapy group, and the follow-up group. The related conditions of HS and MAFLD as well as liver function abnormalities and metabolic syndrome were assessed by liver conventional ultrasound (US) or USE in all groups.
Results
Compare to US-diagnosed HS (21.7%, 36.7%, 38%), higher incidence of HS (60.4%, 78.6%, 68.0%) were detected by USE in the initially diagnosed, chemotherapy and follow-up groups. 50–70% of US-negative patients were detected by USE as having a fatty liver, which was predominantly mild to moderate. Based on the USE diagnosis, there was a higher prevalence of MAFLD in the initially diagnosed group (49.8%), which increased to 68.1% in the chemotherapy group and decreased in the follow-up group (59.1%), with a predominantly decrease of mild-to-moderate cases. BMI and age subgroups showed a higher incidence of MAFLD in patients with BMI ≥ 23 kg/m2 or age ≥ 60 years old. In addition, BCW combined with MAFLD had a higher incidence of liver function abnormalities and metabolic syndrome.
Conclusion
Patients treated with chemotherapy for breast cancer have a higher incidence of HS and MAFLD, especially overweight or obese and menopausal patients. Breast cancer patients with combined MAFLD have higher rates of liver function abnormalities and metabolic syndrome. USE has a higher sensitivity than US and can detect more patients with mild to moderate fatty liver disease, enabling early intervention.