Treatment of disease-negative but mucin-like carcinoma-associated antigen-positive breast cancer patients with tamoxifen: preliminary results of a prospective controlled randomized trial

Kovner, Felix; Merimsky, Ofer; Hareuveni, Mara; Wigler, Neli; Chaitchik, Samario

doi:10.1007/bf00686288

Cited by 26 publications

(10 citation statements)

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“…In a third study, Kovner et al (40 ) randomized asymptomatic patients with increasing mammary cancer antigen concentrations to receive (n ϭ 23) or not receive tamoxifen (n ϭ 26). After a median follow-up of 11 months, 7 of 29 (24%) in the control group had relapsed, whereas none of the 23 patients randomized to receive treatment developed a recurrence (P ϭ 0.012).…”

Section: Surveillance After Primary Treatmentmentioning

confidence: 99%

Serum Tumor Markers in Breast Cancer: Are They of Clinical Value?

2006

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Background: Although multiple serum-based tumor markers have been described for breast cancer, such as CA 15-3, BR 27.29 (CA27.29), carcinoembryonic antigen (CEA), tissue polypeptide antigen, tissue polypeptide specific antigen, and HER-2 (the extracellular domain), the most widely used are CA 15-3 and CEA. Methods: The literature relevant to serum tumor markers in breast cancer was reviewed. Particular attention was given to systematic reviews, prospective randomized trials, and guidelines issued by expert panels. Results: Because of a lack of sensitivity for early disease and lack of specificity, none of the available markers is of value for the detection of early breast cancer. High preoperative concentrations of CA 15-3 are, however, associated with adverse patient outcome. Although serial determinations of tumor markers after primary treatment for breast cancer can preclinically detect recurrent/metastatic disease with lead times of ϳ2-9 months, the clinical value of this lead time remains to be determined. Serum markers, however, are the only validated approach for monitoring treatment in patients with advanced disease that cannot be evaluated by use of conventional criteria. Conclusions: CA 15-3 is one of the first circulating prognostic factors for breast cancer. Preoperative concentrations thus might be combined with existing prognostic factors for predicting outcome in patients with newly diagnosed breast cancer. At present, the most important clinical application of CA 15-3 is in monitoring therapy in patients with advanced breast cancer that is not assessable by existing clinical or radiologic procedures.

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Section: Surveillance After Primary Treatmentmentioning

confidence: 99%

Serum Tumor Markers in Breast Cancer: Are They of Clinical Value?

2006

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“…Accordingly, many centres world-wide perform serial CA15-3 measurements in the routine followup of these patients as for some women it provides the earliest evidence of recurrent disease, for which mul-tiple forms of treatment are available, and intuitively it might be hoped that the earlier treatment is initiated, the better the outcome. Firm evidence demonstrating that early initiation of treatment based on this lead-time improves patient outcome or quality of life is lacking although a small number of papers do suggest a benefit in outcome adopting this approach [20][21][22].…”

Section: Breast Cancermentioning

confidence: 99%

Serum tumor markers and PET/CT imaging for tumor recurrence detection

et al. 2012

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When confronted with a suspicious rise in CA 15.3 in asymptomatic breast cancer patients following primary treatment and negative or equivocal conventional imaging findings, FDG PET/CT allows assessment of the site and extent of the recurring disease with an accuracy of 83 %. Both FDG PET and FDG PET/CT are superior when compared to CT alone for the purpose of recurrence detection in patients suffering from ovarian carcinoma who have completed primary therapy but demonstrate a rising serum CA-125 level. As the global accuracy of CT alone for detection of recurrence of ovarian cancer approximates 80 %, CT scan should be performed upfront to identify the site of recurrence. When confronted with negative or equivocal CT findings, FDG PET alone or FDG PET/CT should be added. In patients with rising erum CEA levels that have undergone primary treatment for a colorectal carcinoma, both FDG PET and FDG PET/ CTs allow detection of tumor recurrence with an accuracy of 95 %, well above that of CT and MRI. Available studies further suggest that FDG/PET findings will affect treatment management in 28-50 % of these patients. The detection rate of both 11C-choline and 18F-choline PET and PET/CT for local, regional, and distant recurrence in prostate carcinoma patients with a biochemical recurrence increases with rising PSA value at the time of imaging and reaches about 75 % in patients with PSA [3 ng/mL. Furthermore, PET and PET/CT with [11C]-and [18F]-choline derivates may be helpful in the clinical setting for optimization of individualized treatment.

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“…In one of the first of these, Jager et al (Jager et al, 1995) randomized patients who had no evidence of metastatic disease, with increasing concentrations of tumour markers (CA 15-3 or CEA) to receive (n = 21) or not receive (n = 26) medroxyprogesterone acetate, reporting that for the untreated patients, the median time interval between increase in marker concentration and detectable metastasis was four months, while for the treated patients it was >36 months. Kovner et al (Kovner et al, 1994) randomized asymptomatic patients with increasing mammary cancer antigen concentrations to receive (n = 23) or not receive tamoxifen (n = 26). After an average follow-up of 11 months, 7 out of 29 patients (24%) in the control group had relapsed, whereas none of the 23 patients who had received treatment developed a recurrence (p= 0.012).…”

Section: Tumour Markers and Surveillance After Primary Treatmentmentioning

confidence: 99%