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<a href="http://doi.org/10.3389/fonc.2021.679163" target="_blank" rel="noreferrer noopener">http://doi.org/10.3389/fonc.2021.679163</a>
Pages
679163
Volume
11
ISSN
2234-943X
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Update Year & Number
August 2021 List
NEOMED Department
NEOMED Student Publications
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Title
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Pseudocirrhosis in Breast Cancer - Experience From an Academic Cancer Center.
Publisher
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Frontiers in Oncology
Date
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2021
2021-07-02
Subject
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breast cancer; CT; liver metastases; METASTASIS; hepatocellular failure; portal hypertension; pseudocirrhosis; CARCINOMA; CHEMOTHERAPY; CIRRHOSIS; LIVER-FAILURE; PORTAL-HYPERTENSION
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Gopalakrishnan D; Shajihan A; Purysko AS; Abraham J
Description
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Background: Pseudocirrhosis is characterized by radiological changes in the liver that resemble cirrhosis, but with more rapid onset and progression. Though reported most frequently in patients with metastatic breast cancer, little is known about its prognostic factors and impact on breast cancer outcomes.; Methods: In this observational study, we reviewed abdominal CT and/or MRI scan reports of all patients with invasive breast cancer diagnosed at our center, during a ten-year period, to identify patients with pseudocirrhosis. Exclusion criteria included lack of baseline imaging, pre-existing cirrhosis, hepatitis B or C, other chronic liver diseases, or heavy alcohol use. Routine descriptive statistical measures were used. Survival distributions were estimated using Kaplan-Meier method, and Cox regression was used for multivariate analysis. Two-tailed p < 0.05 was considered significant.; Results: Eighty-six patients were included - all were females, median age was 57.5 years, and 90% were Caucasian; 86% of primary tumors were hormone-receptor positive and 17% were HER2 positive. Most patients (98%) had metastatic disease with liver involvement (94%), and were heavily pre-treated - 97% with chemotherapy, 85% with hormonal therapy, and 19% with anti-HER2 agents. Median interval from breast cancer diagnosis to pseudocirrhosis was 75.4 months (IQR 35.2-115.3 months). Thirty-six percentage of patients had ≥1 signs of portal hypertension and 49% had ≥1 signs of hepatocellular failure. Pseudocirrhosis led to permanent discontinuation of chemotherapy, endocrine therapy, and all systemic therapies in 29%, 31%, and 20% patients, respectively. Median overall survival from diagnosis of pseudocirrhosis was 10.0 months (95%CI 5.2-14.8 months). On multivariate analysis, coagulopathy, hyperbilirubinemia, hypoalbuminemia, and cancer progression were independently predictive of mortality.; Conclusions: In this largest series, to date, of breast cancer with pseudocirrhosis, the latter was often complicated by portal hypertension and hepatocellular failure, and markedly impacted breast cancer management. Survival was shorter for patients who developed hepatocellular failure. (Copyright © 2021 Gopalakrishnan, Shajihan, Purysko and Abraham.)
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<a href="http://doi.org/10.3389/fonc.2021.679163" target="_blank" rel="noreferrer noopener">10.3389/fonc.2021.679163</a>
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journalArticle
2021
Abraham J
August 2021 List
breast cancer
Carcinoma
Chemotherapy
Cirrhosis
ct
Frontiers in Oncology
Gopalakrishnan D
hepatocellular failure
journalArticle
liver metastases
LIVER-FAILURE
Metastasis
NEOMED College of Medicine Student
NEOMED Student Publications
portal hypertension
portal-hypertension
pseudocirrhosis
Purysko AS
Shajihan A