Pseudocirrhosis in Breast Cancer - Experience From an Academic Cancer Center.

Title

Pseudocirrhosis in Breast Cancer - Experience From an Academic Cancer Center.

Creator

Gopalakrishnan D; Shajihan A; Purysko AS; Abraham J

Publisher

Frontiers in Oncology

Date

2021
2021-07-02

Description

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.)

Subject

breast cancer; CT; liver metastases; METASTASIS; hepatocellular failure; portal hypertension; pseudocirrhosis; CARCINOMA; CHEMOTHERAPY; CIRRHOSIS; LIVER-FAILURE; PORTAL-HYPERTENSION

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Format

journalArticle

Search for Full-text

Users with a NEOMED Library login can search for full-text journal articles at the following url: https://libraryguides.neomed.edu/home

Pages

679163

Volume

11

ISSN

2234-943X

NEOMED Department

NEOMED Student Publications

Update Year & Number

August 2021 List

Citation

Gopalakrishnan D; Shajihan A; Purysko AS; Abraham J, “Pseudocirrhosis in Breast Cancer - Experience From an Academic Cancer Center.,” NEOMED Bibliography Database, accessed August 9, 2022, https://neomed.omeka.net/items/show/11771.

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