Nonalcoholic fatty liver disease after adjuvant therapy in nonmetastatic breast cancer.

Abstract

9587 Background: Nonalcholic fatty liver disease (NAFLD) is an important health problem in the general population. Also NAFLD developing after treatment is very important in cases with cancer especially having long term life expectancy like breast cancer. The aim of this this study is to explore the rate and risk factors of NAFLD in cases with breast cancer receiving adjuvant therapy. Methods: In this prospective study, 201 cases with breast cancer treated by chemo and/or anti-hormonal treatment were included between years 2010-2012. Patients who had ductal carcinoma insitu and metastatic disease and also chronic HBV and HCV infections, chronic liver diseases with other reasons and liver cirrhosis were excluded. Body mass index (BMI) was calculated based on the following formula: weight in kilograms divided by height in meters squared. Diabetes mellitus, hypetension and hyperlipidemia, if there is in past medical history, were documented. NAFLD was deteced by abdominal ultrasound imaging and there was no history of alcohol consumption. Biopsy was performed in 2 patients who had refractory high transaminasis. Results: The patients were divided into three groups. Group I: Patients without NAFLD, Group II: Patients with NAFLD before cancer treatment, Group III: Patients with NAFLD after cancer treatment. There was no difference for age and menopousal status between three groups. Diabetes mellitus, hypetension and hyperlipidemiawere not important risk factors for the development of NAFLD after cancer treatment. (p values 0,085, 0,525, 0,207, respectively). BMI was found to be higher in cases with NAFLD and the occurrence of NAFLD was detected more frequently in obese patients (BMI>30 kg/m2) (p=0,001). Tamoxifen, LHRH analougs and aromatase inhibitors were not found to be asociated with NAFLD (p=0,7, 0,8, 0,5, respectively) while the combination of fluorouracil, antharcycline and cyclophospamide was found to be a risk factor in the development of NAFLD (p=0,02). Conclusions: High BMI (both before and after treatment), obesity and fluorouracil, antharcycline and cyclophospamide combinationin were found to be important risk factors for the occurrence of NAFLD.