Prevalence of hepatic steatosis and metabolic associated fatty liver disease among female breast cancer survivors

To the Editor:Non-alcoholic fatty liver disease(NAFLD)comes to prevail in Asia and,the prevalence in China is reported tobe24%to36%.lilThe prevalence ofNAFLD and its associated medical burden might be underestimated.The diagnosis of NAFLD led to the exclusion of other chronic liver diseases including“excess”alcohols,thus the population with alcoholic consumptions or other liver diseases might be neglected.In March 2020,the international expert consensus proposed a new concept,“metabolic associated fatty liver disease(MAFLD),”“and replaced the earlier term” of NAFLD.2As themost prevalent female malignancy,breast cancer(BC)shares similar risk factors to MAFLD.Higher levels of obesity and physical inactivity are closely correlated to BC and are significant drive for the increasing trends in the prevalence of BC.Some BC survivors may receive chemotherapy and endocrine therapy,both of which are reported to increase the risk of hepatic steatosis(HS),which is the fundamental criteria of the diagnosis of MAFLD.