This study aimed to determine the frequency of hepatic contour abnormalities and signs
of portal hypertension at serial CT in patients receiving chemotherapy for breast
cancer metastatic to the liver.
Materials and Methods
We retrospectively identified 91 women with breast cancer metastatic to the liver
who received chemotherapy and underwent serial CT at our institution between 1998
and 2002. Two readers independently categorized hepatic contour abnormalities on the
final CT examination as none, limited retraction, widespread retraction, or diffuse
nodularity. Readers also recorded the development of hepatic atrophy or enlargement,
ascites, portosystemic collateral veins, and splenomegaly. Interpretative discrepancies
were resolved by consensus. Portal hypertension was defined as the presence of at
least two of the following CT signs: simple ascites, portosystemic collateral veins,
After a median follow-up interval of 15 months (range, 1–46), hepatic contour abnormalities
were seen in 68 of 91 patients (75%) and consisted of limited retraction (n=42), widespread retraction (n=10), or diffuse nodularity (n=16). Portal hypertension was found in 1 of 23 patients without contour abnormalities,
in 1 of 42 patients with limited retraction, in none of 10 patients with widespread
retraction, and in 6 of 16 patients with diffuse nodularity (P<.01).
Hepatic contour abnormalities commonly develop at serial CT in patients undergoing
chemotherapy for breast cancer metastatic to the liver and may be accompanied by signs
of portal hypertension; the latter are particularly, but not exclusively, associated
with the development of diffuse hepatic nodularity.