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'LFTs' test more than the liver.

Biochemical studies of the liver, known to clinicians as "LFTs," can be sensitive to a greater or lesser degree, but they are never specific. The clinician can use them for no more than to infer what is going on in the liver. That is especially true of metastatic liver disease, where it has long been known that, even with diffuse hepatic metastases and after combining laboratory tests with imaging procedures, no more than 75% of metastases can be detected. 1 In this issue ofTHE JOURNAL, Larroquette and coworkers 2 reenforce the view that abnormal findings from hepatic chemistries in patients receiving combination chemotherapy for breast cancer do not necessarily, or usually, signify metastatic disease to the liver. Fifty-nine percent of 190 patients in their retrospective study had abnormal findings from liver chemistries while receiving chemotherapy. Within one year after treatment, however, 90% of those who had developed hepatic enzyme