Elevated CA125 levels in patients with metastatic breast carcinoma

Perey, L; Hayes, DF; Tondini, Carlo; Melle, Guy van; Bauer, Judith; Lemarchand, T.; Reymond, Marc‐André; Mach, Jean‐Pierre; Leyvraz, Serge

doi:10.1038/bjc.1990.353

Cited by 16 publications

(4 citation statements)

References 19 publications

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“…As CA 15‐3 changes correlated with disease course in 60% of cases, the authors deemed this to be the marker of choice. They concluded that CA 125 is useful for monitoring disease course, but it should be reserved for cases without CA 15‐3 elevation (15).…”

Section: Discussionmentioning

confidence: 99%

CA 125 Elevation in Breast Cancer: A Case Report and Review of the Literature

et al. 2004

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A 69-year-old postmenopausal woman with newly diagnosed inflammatory breast cancer was evaluated for a pelvic mass found incidentally during staging computed tomography (CT) scans. Her serum cancer antigen (CA) 125 was greater than 900 U/ml, but laparoscopic examination of the ovaries was normal. Her breast cancer was deemed metastatic by virtue of a supraclavicular lymph node, but she had no visceral or bone metastasis. She was begun on primary chemotherapy and her CA 125 normalized. CA 125 is a tumor-associated antigen that is most commonly seen in advanced ovarian cancer. It is predominantly derived from coelomic epithelium, which explains elevations in benign conditions or other malignancies. The significance of CA 125 elevations in breast cancer is uncertain. Although CA 125 production has been demonstrated in the normal breast, it has been reported most often as a marker of pleural involvement with metastatic breast cancer. Further information on CA 125 in breast cancer is required to delineate its role in the management of this disease.

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Section: Discussionmentioning

confidence: 99%

CA 125 Elevation in Breast Cancer: A Case Report and Review of the Literature

et al. 2004

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“…In addition, carcinoembryonic antigen (CEA) can be detected in the peripheral blood at the time of recurrence, although less frequently than the MUC-1 antigen. CA-125, although traditionally used for monitoring ovarian cancer, can also be detected in the serum of patients with breast cancer (18).…”

Section: Circulating Biomarkersmentioning

confidence: 99%

Promoting Quality and Evidence-Based Care in Early-Stage Breast Cancer Follow-up

Henry

Hayes

Ramsey

et al. 2014

JNCI Journal of the National Cancer Institute

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Evidence-based guidelines for long-term follow-up of early-stage breast cancer patients developed by oncology societies in the United States and Europe recommend that breast cancer survivors undergo regular evaluation with history and physical examination, as well as annual mammography. Routine blood tests, circulating tumor markers, and/or surveillance imaging studies beyond mammography are not recommended in the absence of concerning symptoms or physical examination findings because of lack of supportive clinical evidence. Despite these guidelines, studies have shown that 20% to 40% of oncologists assess serum tumor markers as part of routine monitoring of early-stage breast cancer patients. As part of efforts to both address the financial challenges confronting the health-care system and optimize patient outcomes, the American Society of Clinical Oncology's Cost of Care Task Force identified adherence to breast cancer surveillance guidelines as an opportunity to improve care and reduce cost. However, these recommendations are based on trials done in an era of outdated technology and limited therapeutic options. It is possible that recent improvements in diagnostics and treatments could make earlier detection of recurrent disease important for improving both survival and quality of life outcomes. Research is necessary to further inform optimal breast cancer follow-up strategies, which could impact these recommendations. At this time, outside of well-conducted clinical trials, there is no role for ordering routine serial blood or imaging tests in monitoring for recurrence in early-stage breast cancer patients.

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“…Some breast carcinomas are associated with CA-125 elevations, but the level in this patient was more typical of ovarian cancer. 5 Therefore, recurrent ovarian carcinoma was the source of this patient's recent problem. The hematocrit and the slightly low platelet count were consistent with her exposure to chemotherapy, although the case history includes no relevant details.…”

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confidence: 99%

Case 28-1997

Garber¹,

Olíva²

1997

N Engl J Med

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A 67-year-old woman was admitted to the hospital because of nausea and increasing confusion.The patient had undergone excision and radiation therapy for carcinoma of the left breast 13 years before admission and for carcinoma of the right breast 7 years later. Eight years before admission, she had a hysterectomy with bilateral salpingo-oophorectomy for ovarian carcinoma. Two years before admission, a sigmoid resection with a colostomy was performed because of recurrent tumor. The patient had undergone multiple chemotherapy regimens, including cyclophosphamide, methotrexate, and fluorouracil for breast cancer and paclitaxel, cisplatin, and carboplatin for ovarian cancer. Eighteen days before the current admission, a computed tomographic (CT) scan of the abdomen and pelvis revealed a retroperitoneal mass. Surgical exploration revealed carcinomatosis with diffuse studding of the peritoneum, colon, and liver; microscopical examination of a biopsy specimen showed metastatic, poorly differentiated carcinoma. The patient was discharged with plans to reinstitute chemotherapy.During the week before the current admission, diarrhea and nausea developed, with abdominal pain and increasing confusion. Twice in the three days before admission, the patient was seen in the emergency room, where a cranial CT scan showed minimal, nonspecific hypointense white-matter foci in both cerebral hemispheres but no evidence of metastasis. She was readmitted to the hospital.The patient had a history of malignant hypertension with cortical blindness after the first course of cisplatin. She was taking atenolol, ranitidine, and ox-ycodone-acetaminophen. There was no history of fever, chills, or sweats.The temperature was 37.3°C, the pulse was 100, and the respirations were 20. The blood pressure was 160/90 mm Hg. No lymphadenopathy was found. The head, neck, and lungs were normal. A grade 2 systolic murmur was heard over the precordium. The colostomy site was clear, the bowel sounds were normal, and no masses or enlarged organs were palpated. There was no peripheral edema. On neurologic examination, the patient was oriented to person and location but could state only the year, not the month or day; she could not perform serial subtractions of 7 from 100.The urine was normal. The levels of urea nitrogen, creatinine, uric acid, bilirubin, calcium, phosphorus, magnesium, amylase, and thyroid-stimulating hormone were normal. The results of other laboratory tests are shown in Tables 1 and 2. A blood culture was negative. A CT scan of the abdomen and pelvis revealed soft-tissue mesenteric masses, fatty change in the liver, and a moderate left pleural effusion. A urine culture yielded a few mixed microorganisms, and a stool assay was negative for Clostridium difficile toxin.Atenolol and omeprazole were administered. The temperature ranged between 36.7°C and 37.8°C during the patient's hospital stay.On the second hospital day, the patient was slightly less confused but reported visual changes that she could not describe and had difficulty deciding how ...

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Elevated CA125 levels in patients with metastatic breast carcinoma

Cited by 16 publications

References 19 publications

CA 125 Elevation in Breast Cancer: A Case Report and Review of the Literature

CA 125 Elevation in Breast Cancer: A Case Report and Review of the Literature

Promoting Quality and Evidence-Based Care in Early-Stage Breast Cancer Follow-up

Case 28-1997

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