Hayley M. Heers,Lida  Mina,Shakeela W  Bahadur,Shannon  Lim,
Accelerated Onset of Liver Failure after Prolonged Adjuvant Tamoxifen Use in Breast Cancer Patients
Clinical Oncology and Research
2020
2613-4942
http://dx.doi.org/10.31487/j.COR.2020.04.11
https://www.sciencerepository.org/accelerated-onset-of-liver-failure-after-prolonged-adjuvant-tamoxifen-use_COR-2020-4-111 
Abstract: Use of adjuvant endocrine therapy for women with hormone-receptor (HR)-positive breast cancer has
become the standard of care. Tamoxifen, an orally available selective estrogen receptor modulator (SERM),
is a commonly used endocrine therapy agent currently recommended for use in pre- or post-menopausal
women with HR-positive breast cancer. Current evidence suggests that prolonged tamoxifen use may be
implicated in causing hepatotoxicity which may manifest as non-alcoholic steatohepatitis (NASH),
cholestasis, cirrhosis, or hepatic necrosis. We herein present two cases of suspected tamoxifen-induced
NASH resulting in fulminant liver failure. We also discuss literature surrounding tamoxifen-related
hepatoxicity and implications in clinical practice.Keywords: Tamoxifen, breast cancer, nonalcoholic steatohepatitis, NASH, hepatotoxicity