Prevention of Tamoxifen-related Nonalcoholic Fatty Liver Disease in Breast Cancer Patients

Background

Tamoxifen is commonly used to prevent breast cancer recurrence. Studies have confirmed the association between tamoxifen and nonalcoholic fatty liver disease (NAFLD), with the results indicating the need for aggressive management of this side effect. We assessed the potential risk factors for and identified the possible protective factors of tamoxifen-related fatty liver.

Materials and Methods

We enrolled patients with a history of breast cancer, aged 20 to 70 years, who had received with tamoxifen treatment within the past 5 years. We obtained the initial data and performed a follow-up blood test and ultrasound examination to compare the differences before and after tamoxifen treatment. The patients were divided into relatively normal and fatty liver groups.

Results

Of the 266 enrolled tamoxifen-treated patients, 143 (53.8%) and 123 (46.2%) were in the relatively normal and fatty liver groups, respectively. The initial body weight (57.6 ± 9.3 kg vs. 60.9 ± 10.3 kg; P = .006) and body mass index (BMI; 23.4 ± 3.8 kg/m² vs. 25.0 ± 4.2 kg/m²; P < .001) were lower in the relatively normal group. An initial BMI of ≥ 22 kg/m² was a potential risk factor for tamoxifen-related NAFLD (hazard ratio HR], 1.58; 95% confidence interval CI], 1.00-2.48; P = .048). In contrast, a weekly exercise duration of ≥ 150 minutes reduced the risk (HR, 0.47; 95% CI, 0.31-0.69; P < .001).

Conclusion

The results from our study suggest that a BMI of ≥ 22 kg/m² is a potential risk factor for tamoxifen-related fatty liver and exercise is a possible protective factor.