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Breast Cancer Tumor Markers and Other Tests

At the time of diagnosis it is not necessary to routinely order bone scans , CAT scans or PET scans in early cases (see NCCN guidelines and the ASCO guidelines. Some patients with breast cancer will be found to have elevated chemicals (tumor markers) in their blood which can be used to monitor responses and check for relapses. The CA 27.29 on average will start rising 5.3 months prior to any symptoms in patients with a relapse. The CA 15.3 has been shown to correlate with the stage as noted, and the CA 27.29 may be more sensitive. (For reasons somewhat complicated these tests are not officially recommended see ASCO below.) Also see follow up testing from NCCN.

Stage	Elevated CA 15.3
I	5 - 30%
II	15 - 50%
III	60 - 70%
IV	65 - 90%

Stage	Elevated CA 27.29	Elevated CA 15.3
I	29%	15%
II	36%	23%
III	59%	54.5%

Despite the apparent benefits of measuring these markers, scientific studies have not shown a real clinical benefit to patients leading the ASCO to discourage the routine use, see below and the section on follow-up tests.and the ASCO patient guide

American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast Cancer

go here

CA 15-3 AND CA 27.29 AS MARKERS FOR BREAST CANCER

2007 recommendation for CA 15-3 and CA 27.29 as screening, diagnostic, or staging tests.

Present data are insufficient to recommend CA 15-3 or CA 27.29 for screening, diagnosis, and staging. There is no change from the original guideline.

CARCINOEMBRYONIC ANTIGEN AS A MARKER FOR BREAST CANCER

2007 recommendation for carcinoembryonic antigen for screening, diagnosis, staging, or routine surveillance of breast cancer patients after primary therapy.

Carcinoembryonic antigen (CEA) is not recommended for screening, diagnosis, staging, or routine surveillance of breast cancer patients after primary therapy. There is no change from the guideline published in 2000.

CIRCULATING TUMOR CELLS AS MARKERS FOR BREAST CANCER (Note. This topic is new to the guideline)

2007 recommendation for circulating tumor cell assays.

The measurement of circulating tumor cells (CTCs) should not be used to make the diagnosis of breast cancer or to influence any treatment decisions in patients with breast cancer. Similarly, the use of the recently US Food and Drug Administration–cleared test for CTCs (CellSearch Assay; Veridex, Warren, NJ) in patients with metastatic breast cancer cannot be recommended until additional validation confirms the clinical value of this test.