Evaluation of Breast Cancer Radiotherapy Induced Liver Fibrosis by Elastography

Abstract

Aim: Radiotherapy is an essential part of breast cancer standard therapeutic regimen. Based on anatomical vicinity, liver is susceptible to radiation induced injury at doses more than 30 gray. This study designed to determine the relation between breast cancer radiotherapy and liver fibrosis. Methods: In this case control descriptive study, the intervention group selected among patients whom underwent radiotherapy for breast cancer. The patients evaluated for viewpoint of BMI, age and liver enzymes and the ones with any kind of chronic liver disease excluded. Overall 60 breast cancer cases divided into 3 groups as: breast cancer without radiotherapy (group A) and left or right breast cancer treated with radiotherapy (groups B and C respectively). All of the patients evaluated by liver fiber scan. Results: Average age of patients in groups A, B and C were 47±8, 49±10 and 49±10 years respectively (P=0.560). Mean BMI as kg/m2 were similar among 3 groups (A 26±2, B 28±3 and C 24±4) (P=0.021). Average sessions of radiotherapy were 20±9 and 27±6 in groups B and C respectively with no course at all in group A. Average score of fiber scan as KPa in groups A, B & C were 6±2.3, 7.2±2.6 and 6.9±2.9 respectively (P=0.38). Conclusion: In this study we found no meaningful relation between breast cancer radiotherapy and liver fibrosis in spite of anatomical vicinal of breast and liver. It seems that breast radiotherapy even at doses higher than 40 Grays has no effect on liver stiffness although it has been advised to be careful and in case of any disturbance in liver function tests, supporting and diagnostic measures be perform.