| Summary: | Background : Tamoxifen is one of Selective Estrogen Reseptor Modulators
(SERMs) that serves as an anti-estrogen agent and aims to block the effects of
estrogen on breast cancer tissue making it beneficial to cancerous cells death
microscopically. In the liver, tamoxifen interfere s with metabolism of fat in the
liver which eventually will lead to the accumulation of fat, especially
triglycerides, and cause fatty liver. Ultrasonography is modality of choice and
most widely used to detect the presence of fatty liver due to non-invasive, not
giving radiation, easily available, and affordable cost with a sensitivity of 82 to
89% and a specificity of 93%. Degree of fatty liver on gray-scale ultrasound
divided into degrees 0, 1, 2 and 3. Infiltration of fat in the liver blood vessels
causes a decrease in intrahepat ic vascular compliance which can be examined
using Doppler hepatic vein spectral ultrasound. Hepatic vein spectral ultrasound
can be divided into normal, a triphasic waveform , and abnormal, a biphasic or
monophasic waveform.
Objectives : to compare the incidency of fatty liver (degree of fatty liver, hepatic
vein spectral waveform and its correlation using ultrasound examination in breast
cancer patients with and without tamoxifen therapy.
Materials and Methods : This is a cross sectional observational study . Sampling
technique by consecutive non-random sampling. This study used questionnaires
and imaging of grey-scale ultrasound examination of the liver and right hepatic
vein spectral Doppler ultrasound. Statistical analysis used was K-S test.
Results: Mode breast cancer diagnosed age range was 50-60 y.o. and the youngest
age was 28 y.o. None of the subjects was obese. Mode histopathology was
infiltrative ductal Ca. The mean use of tamoxifen was 19+5,87 months. There is
an increase in the incidency of degree 1 and 3 fatty liver in breast cancer patients
with tamoxifen therapy, but this was not statistically significant. Hepatic vein
spectral abnormalities with monophasic waveforms also increased in tamoxifen
therapy compared with those without tamoxifen therapy , but this was not
statistically significant. There was no significant correlation between degree of
fatty liver and hepatic vein spectral waveform.
Conclusions : Increased incidency of degree 1 and 3 fatty liver and abnormal
spectral monophasic waveform in breast cancer patients with tamoxifen were not
statistically significant. There was no significant correlation between the
incidency of degree of fatty liver and hepatic vein spectral waveform.
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