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Hepatic Capsular Retraction in Metastatic Carcinoma of the Breast Occurring with Increase or Decrease in Size of Subjacent Metastasis

¹ Department of Radiology, Division of Abdominal Imaging and Intervention, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115.
² Institute for Radiology, Rorschacherstrasse 95, Kantonsspital St. Gallen, St. Gallen 9007, Switzerland.

OBJECTIVE. We evaluated the prevalence and significance of hepatic capsular retraction in hepatic metastases from breast cancer and correlated these with metastatic number, size, change in size over time, breast tumor histopathology, chemotherapeutic regimen, and tumor-receptor status.

MATERIALS AND METHODS. Abdominal CT scans of 200 consecutive women with breast carcinoma (mean age, 57 years; range, 33–81 years), obtained over a 7-month period, were retrospectively reviewed. Fifty-eight women had hepatic metastases. Two hundred seventy-two CT scans, including present and prior examinations (mean [± SD], 4.6 ± 2 per patient), were evaluated. The number and diameter of liver metastases at all examinations, chemotherapeutic agents used, histopathologic diagnosis of breast tumor, and tumor-receptor status were compared in patients with and without capsular retraction. Descriptive analyses of the variables and comparisons of means and proportions as well as correlations were conducted.

RESULTS. Hepatic capsular retraction was observed in 29 patients with hepatic metastases (50%). Retraction ranged from 1 to 10 mm in depth. Patients with capsular retraction had significantly larger metastases than those without retraction (p < 0.05). The associations between retraction and increase in size of the subjacent metastasis and between retraction and decrease in size were statistically significant (p < 0.05). Capsular retraction was independent of the number of hepatic metastases, histopathologic diagnosis, tumor-receptor status, and chemotherapeutic regimen.

CONCLUSION. Hepatic capsular retraction is common in patients with hepatic metastases from breast cancer and is associated with larger metastases and both increase and decrease in subjacent lesion size. It is unrelated to lesion number, histopathology, receptor status, or chemotherapeutic regimen.

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