ABSTRACT
It was the hope of most clinical enzymologists that there would be a sufficient increment in enzyme levels at the site of origin of the carcinoma so that the changes could be easily detected in the body fluids. Leaving aside the impossible dream, however, enzyme determinations do play a role in the diagnosis and treatment of carcinoma. Although this text is concerned with the biochemistry of women, any discussion of this topic must, like the women liberationists, cross sex lines. In women, increases in alkaline phosphatase levels have been reported with bone and hepatic metastases to primary breast carcinoma. Elevated alkaline phosphatases in anicteric serum are often the first indication of metastatic spread. In a study in 1956, Reynolds et al. reported that of 70 cases of metastatic carcinoma in breast, 52 had levels exceeding the upper limits of normal. The patients with histological proven malignancy had invasive ductal carcinoma, medullary carcinoma, and a malignant intraductal papilloma.
