Breast carcinoma is a most frequent cancer in women and main reason of death [1]. Breast cancer has a large domain of clinical, genetic, and biochemical features. In comparison to Western countries, Asian countries have a substantially lower incidence rate of breast cancer. Breast cancer is become more common in all parts of world. The majority of the increase may be found in underdeveloped countries [2].

Patients undergoing chemotherapy generally have a good prognosis, with many surviving an average of 13 months [3]. Liver metastases are detected in 55% to 75% of all autopsies performed on individuals which died from breast cancer [4]. Furthermore, liver metastases are the most common cause of death for patients [5]. Consequently, early detection of cancer liver metastases is beneficial for prompt treatment, leading to improved prognosis.

At presentation, 92 percent of all patients had abnormal liver function tests, with (GGT) and (ALP) being the most often increased enzymes. In addition, and over half of all patients had aspartate transaminase (AST) values that exceeded the upper limit of normal [6].

The origin of the onset of cancer in the body is the subject of multiple theories. The first is that the mistake, known as a state of "change" or mutation, happened in the DNA at the division. As exposure to carcinogens like tar in cigarette smoke increases, so does the rate of DNA mistakes at division. Depending on their causes, many of these mistakes happen in the human body, but the immune system eliminates them because it identifies how they differ from the other cells. These cells can occasionally be mistaken for other cells by the immune system, which leads to their division and eventual development of cancer [7], According to one recent explanation, the reason is a straightforward genetic flaw that the immune system is unable to detect. Over time, this imbalance leads to the escaping cell control, which in turn leads to cancer. According to this notion, certain tumor forms can occur in many families. and the When then Some body cells naturally die during our lifetimes, and the body divides to make up for the lost cells. The cell divides into two cells after creating a second copy of its DNA [8].

This is a simplified version of what occurs in the cell; the  division  process  is  more  intricate.  In  order  for  our bodies to grow, replace, or repair damaged tissue, cells typically divide on a regular basis. We are healthy when our cells function properly, but we become ill when that system malfunctions. In the case of cancer, aberrant cells proliferate dramatically and continuously, overwhelming the injured organ and creating the so-called tumor [9], rather than merely replacing damaged cells.

The liver functioning   and kidney functioning) were tested in this study to determine the levels of various components. The levels of essential substances such as liver transaminase (SGOT, SGPT), alkaline phosphatase (ALP), bilirubin and level of blood glucose were examined  as the liver function tests

The kidney function test included a group of serum assays that measure creatinine, urea, and uric acid concentration in serum and are used to estimated efficiency of kidneys function.

MATERIALS AND METHODS

The present study was carried on sixty persons involved 30 patients have breast cancer and 30 healthful person as control group at Al-Diwaniyah Teaching Hospital.. blood samples were obtained from the control and patients; blood glucose was estimated and serum isolated from blood by centrifugation for estimated total cholesterol, total bilirubin, liver enzymes (SGPT, GOT, AlP ) uric acid, urea and Creatinine.

Statistical analysis

The results were statistically evaluated using the Graphpad Prism 7 program. A t-test was employed to determine the significance and a probability level of less than 5% was utilized to compare the means.

Liver function

Figure 1 indicated to the levels of blood glucose, total bilirubin, cholesterol and liver enzymes (GPT, GOT and ALP) respectively in the serum of patients have breast cancer. A results of this study recoded that increased glucose levels in blood, cholesterol and ALP enzyme in breast  cancer  patients  compared  with  healthy  group. A results of bilirubin levels (Figure 1) revealed decrease significant differences (p<0.05) in patients have breast cancer compared with healthy group. While, no important differences (p>0.05) that recorded in GPT and GOT between patients have breast cancer and healthful group.

Figure 1: The levels parameter liver function (total bilirubin, cholesterol glucose and liver enzymes GPT, GOT and ALP in the breast cancer patients

Figure 2: The levels parameter kidneys function (Urea, creatinine & uric acid) in the breast cancer patients.  

Hepatotoxicity is defined as liver impairment caused by an excess of hepatotoxins or hepatotoxicants [10]. Necrosis, fibrosis, steatosis, cholestasis, and vascular damage are all exacerbated by hepatotoxicity [11]. The enzyme levels of GPT, GOT, and ALP are the primary components of the liver functional test. 

Aspartate is converted to oxaloacetate by GOT and alanine is converted to pyruvate by GPT.  Some investigations have found these transaminases activities are higher in carcinogenic patients have breast cancer than in undangerous breast cancer patients [12,13]. Increased SGOT and SGPT levels indicate a problem with liver and renal function, that may be caused by tumor development [13].

A progressive elevation of serum alkaline phosphatase (ALP) activity in women with breast cancer is a marker of metastasis [14]. Elevated ALP level was seen in the current study during various treatment cycles. This signifies that breast cancer has spread to the bone or the liver. ALP concentrations in non-metastatic breast cancer were not found to differ significantly in several investigations [15].

In invasive breast cancer patients, the association between blood bilirubin levels and longevity was investigated, and the results revealed that hyperbilirubinemia was linked to a poor prognosis [16]. Non-metastatic patients have breast cancer with higher serum total bilirubin have Survival is generally better. Of those with low serum bilirubin, according to one study [17]. This could be related to the fact that the patient population is different. The level of serum bilirubin in invasive and non-metastatic women with breast cancer may have varied prognostic effects [17].

The amount of glucose in the blood plays a key role in chemotherapy treatment. Effect of high blood sugar on bioactivity of cancerous cells and its therapies has been studied extensively [18]. Hyperglycemia following chemotherapy for hematologic and solid malignancies has been linked to higher toxicity in some studies.

Kidneys Function 

Figure 2 indicated to levels of (urea, uric acid & creatinine) in serum of breast cancer patients. The results of this study investigated that significant increased (p<0.05 the levels of urea in serum of patients have breast cancer compared with healthful group. While, the results of uric acid and creatinine levels (Figure 2) revealed decrease significant differences (p<0.05) in patients have breast cancer compared with healthful group.

Blood urea is a sensitive biomarker of kidney disease. In contrast to prior research [19] the current investigation found that BUN levels were higher than the typical reference range. Devi et al. (2015) discovered that metabolite of waste quantities increased weakly and declined in a normal limit. Patients' urea (BUN) levels were within acceptable limits.

Creatinine levels in the blood are thought to be a more sensitive renal function measurement than BUN. Because renal disease has been the only cause of high creatinine levels. In contrast to prior research [19] no statistical significance correlation between creatinine levels and chemotherapeutic courses was discovered in this investigation. Devi et al. found that creatinine levels between 1.0 and 2.0 mg/dl had an enhanced value.

Several studies have been conducted on the relationship between serum uric acid and outcomes in breast cancer patients. [20,21]. High serum uric acid levels have been linked to many diseases, the most common of which is kidney failure [20]. Uric acid is a pro-oxidant and a sign of oxidative stress that also serves as an antioxidant [22]. 

During different treatment regimens, serum uric acid levels fell and then slightly increased, comparable to earlier studies [23]. Increased uric acid levels were found to be a protective factor in these investigations [24]. Veni et al. (2011) found that mistreated women with breast cancer had a considerable increase in uric acid levels, possibly caused by elevated oxidative stress. Similar to prior research [25], the current investigation indicated that uric acid levels were greater than the standard limits.

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