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Potential of these effects may be heightened in patients with breast cancer treated with hepatically metabolized chemotherapeutics (e.g., cyclophosphamide, paclitaxel, anthracyclines) or tyrosine kinase inhibitors in which drug-drug interaction-based elevation or lowering of enzyme activity can result in supra-therapeutic drug concentrations, accumulation of toxic metabolites and compromised detoxification of reactive oxygen species facilitating hepatocellular distress