Publication: Evaluation of fatty liver in breast cancer patients and its metastatic potential
Date
2021
Authors
Ahmad, Nor Hayati
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Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) has a higher prevalence
among breast cancer patients compared to the normal population and is one of the
risk factors for extrahepatic carcinogenesis. It has also increased the risk of primary
tumour progression, risk of distant metastasis, and tumour recurrent. However, to
date, not many clinical studies were done to evaluate fatty liver and metastatic risk.
Thus, further clinical study is needed. This study aims to evaluate the association of
fatty liver with distant metastasis and metastatic site.
Methods: A cross-sectional study was conducted in Hospital Universiti Sains
Malaysia (HUSM), Kelantan, Malaysia on histopathological confirmed female breast
carcinoma patients from January 2014 till December 2020. The evaluation of fatty
liver done were made on a plain CT abdomen images with reference of contrasted
images. Three regions of interest (ROI) were drawn on the liver and spleen and the
Hounsfield unit (HU) was documented. Liver to splenic ratio (L/S ratio) was
calculated by dividing the average liver HU to splenic ratio. L/S ratio of less than 1.0
was taken as fatty liver. Evaluation of distant metastasis was also done. The
association of fatty liver with distant metastasis and metastatic site were evaluated.
Results: Out of 624 screened subjects, a total of 332 subjects with
histopathologically proven breast carcinoma patients that underwent CT scan stage
including thorax, abdomen, and pelvis scans were included as participants in th is
study. Mean age was 53 years (SD±10.93) ranging from 28 to 82 years old, 45.5% (n—151) had tumour size of > 5 cm, 51.8% (n=l 72) had metastasis at diagnosis. The most common metastasis site was the lung, followed by bone and liver. The
prevalence of fatty liver in the study population was 27.2% (n=91). This current
study showed association of fatty liver with distant metastasis. Association of fatty
liver with lung metastasis were also demonstrated. However, there was no
association between fatty liver and distant metastasis or with the site of metastasis in
tumour size of <5cm.
Conclusion: Prevalence of fatty liver in breast carcinoma patients in our study was
27.2%, which corresponds to most of other studies. Considering the existing studies
investigating the relationship between fatty liver and breast cancer, our study results
showed a similar finding of an association of fatty liver with distant metastasis.
Association of fatty liver with distant metastatic site to lung and pleura were also
demonstrated. However, no association between fatty liver and distant metastasis or
metastatic sites in tumour size of <5cm.
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Keywords
Breast neoplasms