Hepatitis B virus reactivation was first described in the mid-1970s. Since then it has been shown to be a complication of anticancer chemotherapy. Reactivation during chemotherapy is not rare, and hundreds of articles are published annually on this topic. However, there has rarely been a study on diagnosing and prevention of HBV reactivation among breast cancer patients. Chemotherapy has been the mainstay of breast cancer treatment. It not only disrupts liver function, but also could assist in the replication of HBV DNA, which leads to HBV reactivation. The consequences of HBV reactivation range from self-limited conditions to fulminant hepatic failure and death.
It also leads to premature termination of chemotherapy or delay in treatment schedules. With the rise of breast cancer incidence around the globe and the continuing trend in the availability of an array of chemotherapeutic regimens, the incidence of HBV reactivation among breast cancer patients is likely to increase further in future if current screening and antiviral treatment practices mentioned in the guidelines do not change. HBV reactivation is almost always preventable, and therefore identifying patients at risk by HBV screening followed by antiviral prophylaxis is essential. Unfortunately, these two crucial means are underestimated. Increased awareness of HBV reactivation among healthcare providers who prescribe chemotherapy, adoption of routine HBV screening, and linking the results of screening to antiviral prophylaxis are needed to reduce the incidence of this potentially fatal but preventable disorder.