Alkaline Phosphatase and Simple Gray Scale Ultrasonography in Detecting Liver Metastasis in Breast Cancer Patients: A Comparison between Bone Scan Positive and Bone Scan Negative Patients

Abstract

Alkaline Phosphatase (s-ALP) has been extensively used to monitor the disease and screen the patients for cancer metastasis. Both the baseline s-ALP and changes in s-ALP have been reported as prognostic factors for treatment effect and survival in bony and liver metastatic breast cancer. Aims: To signify the role of serum Alkaline Phosphatase in combination with simple gray scale ultrasound in detecting and confirming liver metastasis in breast cancer patients with and without bone metastasis. Study Design: It was a cross sectional comparative study. Place and Duration of Study: Conducted at Karachi Institute of Radiology and Nuclear Medicine between 2011 and 2012. Methodology: Histopathologically confirmed cases of breast cancer were identified and bone scans were conducted. 100 females with positive and 100 females with negative bone scan belong to any age group were included. Liver ultrasound of all subjects was conducted, using simple gray scale ultrasound machines. Serum Alkaline Phosphatase was measured with the help of semiautomatic biochemical analyzer. Results: Liver metastasis was found by ultrasound in both bone scan positive and bone patients. Serum ALP levels found very high (P value< 0.001) in patients with liver metastasis. Conclusion: Positive liver ultrasound, using simple gray scale and high serum ALP levels strongly correlated with positive liver metastasis in breast cancer. Liver metastasis was found more frequent among bony metastatic breast cancer. A combination of routinely done, low cost test in determination of liver metastatic breast cancer will prove better detecting tools especially in poor resources settings.