{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T10:31:58Z","timestamp":1780050718343,"version":"3.53.1"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Tamoxifen is a widely used endocrine treatment for breast cancer, also responsible for drug\u2010induced steatotic liver diseases. This study aimed to investigate the frequency, clinical course and risk factors for tamoxifen\u2010induced liver injury in patients with breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 192 patients with breast cancer who initiated tamoxifen therapy between January 2008 and December 2017, undergoing blood tests and abdominal ultrasonography after receiving tamoxifen for at least 1\u00a0year. Liver injury was defined as alanine transaminase and\/or alkaline phosphatase levels exceeding twice the upper limit of the normal range. We explored the risk factors for CTCAE grade\u00a0\u2265\u00a02 tamoxifen\u2010induced liver injury and validated the results with a cohort of additional 166 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 192 patients, 30 (15.6%) experienced tamoxifen\u2010induced liver injury, including 13 patients with grade\u00a0\u2265\u00a02 liver injury. Although most patients with grade 1 liver injury experienced spontaneous resolution, several patients with grade\u00a0\u2265\u00a02 liver injury required treatment interruption\/discontinuation or developed persistent liver injury. Progression to cirrhosis was suspected in two (1.0%) patients. High body mass index (BMI), diabetes, dyslipidemia and pre\u2010existing liver steatosis were significantly associated with an increased risk of grade\u00a0\u2265\u00a02 liver injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Tamoxifen\u2010induced liver injury was observed in 15.6% of the patients. Metabolic factors, such as high BMI, diabetes, dyslipidemia and pre\u2010existing liver steatosis, were considered potential predictors of CTCAE grade\u00a0\u2265\u00a02 liver injury. Collaboration with gastroenterologists should be encouraged in patients with grade\u00a0\u2265\u00a02 liver injuries, where spontaneous remission is uncommon.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70059","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T17:00:31Z","timestamp":1760461231000},"page":"594-603","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tamoxifen\u2010Induced Liver Injury in Patients With Breast Cancer: Frequency, Risk Factors and Clinical Course"],"prefix":"10.1111","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4624-0731","authenticated-orcid":false,"given":"Ayako","family":"Ueno","sequence":"first","affiliation":[{"name":"Department of General Surgery Kurashiki Central Hospital  Kurashiki 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