Postoperative Follow-Up of Breast Cancer Patients: Overview and Progress in the Use of Tumor Markers

Abstract

The role of serial measurement of serum tumor-associated antigens (TAA) in the postoperative follow-up of breast cancer patients is not considered by most authors. The authors of this article review the literature and original data showing benefits from the use of TAA in the postoperative follow-up of breast cancer patients. An increase in the lead time from the first pathological finding to the definite evidence of distant metastases has been observed in follow-up studies which have used TAA compared to those which did not use them. The sensitivity and specificity of TAA in the diagnosis of distant metastases have been markedly improved by selecting an appropriate combination of TAA and by identifying specific conditions associated with breast cancer responsible for false-positive results as well as by adopting a ‘dynamic’ evaluation of multiple successive determinations of TAA. TAA accurately predict patients with bone metastases and can be used to guide imaging techniques. The anticipation of distant metastasis by TAA can be used to initiate a relatively early treatment which has been shown to prolong overall survival in a previous study. It is hoped that these data will stimulate further trials including TAA in the follow-up of breast cancer patients.

A Comparative Study of Bone Scan Findings and Serum Levels of Tumor Marker CA15-3 in Patients with Breast Carcinoma

“…Number of subjects studied is small to establish a definite correlation between CA15-3 and bone scan findings. But many reported data from other authors support our results and suggests that elevated value of CA15-3 and bone scintigraphy are useful for early identification of bone metastasis in patients with breast cancer [1,2,9,11].…”

“…Many studies have reported that the incidence of bone metastasis differs according to the clinical stage of breast cancer [2,[4][5][6][7][8]15]. Autopsy studies of breast cancer [9][10][11][12][13][14] have demonstrated a high proportion of breast cancer patients with bone metastasis (50-85%). The affinity of breast cancer to spread metastases in bones is one major reason for high mortality rate of breast cancer surgery is the treatment of choice for breast cancer patients without metastases.…”

Screening for Prostate Specific Antigen in Various Types of Breast Tumor

“…CA15-3 level increased in 10% stage I breast cancer disease, 20% stage II disease, 40% stage III disease, and 75% with stage IV disease (Duffy 2006). Elevated levels of this biomarker were detected among certain benign diseases, primary breast carcinoma (Coveney, Geraghty et al, 1995) and in patients with advanced adenocarcinomas (Nicolini and Carpi 2000).…”

Utility of a Serum Tumour Marker Panel in the Post-Operative Follow-Up of Breast Cancer Patients with Equivocal Conventional Radiological Examinations

“…The serum tumour marker level itself was much less important than the time-related change in values. In patients with a constant elevation or progressive increase of one or more tumour markers, tumour relapse was suspected, depending on whether the increase could be explained by any clear concomitant benign pathology indicated by the case history and/or laboratory exams [10][11][12].…”

“…The lesions felt to be equivocal at liver echography were clarified by computed tomography or fine-needle aspiration cytology guided by liver echography when possible. The patients with equivocal radiological examinations and concomitantly not suspected of relapse with the CEA-TPA-CA15.3 tumour marker panel were regularly followed up as described above [8,9,12].…”