title: Hepatic Lesions Detected after Mastectomy, in Breast Cancer Patients with Hepatitis Background May Need to Undergo Liver Biopsy to Rule Out Second Primary Hepatocellular Carcinoma.
abstract: OBJECTIVE
  Liver metastasis is a common phenomenon in breast cancer patients. Hepatic lesions detected in breast cancer patients may be easily misdiagnosed as metastatic sites, rather than being treated as primary foci. This descriptive study aims to investigate the clinicopathological characteristics of second primary hepatocellular carcinoma in breast cancer patients and to infer in which circumstances liver biopsy is needed.
  
  
  METHODS
  Eighty-one consecutive breast cancer patients with hepatic lesions admitted to our department were retrospectively studied and analyzed from January 2009 to March 2014 according to Warren and Gates' criteria for second primary cancers.
  
  
  RESULTS
  Second primary hepatocellular carcinoma was observed in sixteen of seventy eight patients with breast cancer. There was a significant difference in HBV status between the second HCC group and liver metastases group (P<0.0001). There was no significant difference in age (P = 0.2254) and family history (P = 0.1160) between second primary HCC and metastases group. Two of these patients had synchronous second primary hepatocellular carcinoma and the remaining fourteen patients had metachronous second primary HCC. All sixteen patients were infected with hepatitis, including hepatitis virus B and C, or resolved HBV infection.
  
  
  CONCLUSIONS
  Breast cancer patients with either HBV infection or resolved HBV infection, regardless of an elevated AFP level, may receive liver biopsy to avoid unnecessary and inappropriate treatments for metastasis. Awareness of second primary HCC in breast cancer patients needs to be emphasized.
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Qi-wen
authors.initials: QW
authors.lastname: Chen
authors.affiliation: Department of Medical Oncology, Shaoxing Hospital, China Medical University, Shaoxing, China.
authors.forename: Hai-jin
authors.initials: HJ
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Shaoxing Hospital, China Medical University, Shaoxing, China.
authors.forename: Ya-nan
authors.initials: YN
authors.lastname: Chen
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Zhou-yu
authors.initials: ZY
authors.lastname: Ning
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Song
authors.initials: S
authors.lastname: Gao
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Ye-hua
authors.initials: YH
authors.lastname: Shen
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Zhi-qiang
authors.initials: ZQ
authors.lastname: Meng
authors.affiliation: Department of Pharmacy, Albany College of Pharmacy and Health Sciences, Albany, New York, United States of America.
authors.forename: Sonya
authors.initials: S
authors.lastname: Vargulick
authors.affiliation: Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.|Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Bi-yun
authors.initials: BY
authors.lastname: Wang
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
mesh_terms: D001706:Biopsy; D001943:Breast Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D003131:Combined Modality Therapy; D005260:Female; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008408:Mastectomy; D008875:Middle Aged; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary; D012189:Retrospective Studies