Serum alkaline phosphatase determination. Value in the staging of advanced breast cancer

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Abstract
A retrospective study of 146 patients with metastatic disease was undertaken to verify the clinical impression that radionuclide scanning rarely, if ever, discloses hepatic metastases in breast cancer patients with normal serum alkaline phosphatase (AP) levels. Only 2 of 39 patients with abnormal liver scans had normal AP levels, and liver scans are apparently not necessary as a routine screening method for liver metastases when the AP level is normal. In contrast AP levels were not predictive of bone scan results. All patients with a 2-fold or greater elevation of the AP level had abnormal bone, liver or bone and liver scans. Routine AP determinations provide accurate staging information, and their proper use can decrease the cost of initial and follow-up examination of patients with breast cancer.