tumor markers and need for further testing

Question

I had a question  regarding the tumor marker 27.29-- I'm 39 years old  and  finished 4 cycles w/ AC  about 4-5 months ago, and RT about 2months prior to first testing the markers, for a moderately well differentiated stage 1 tumor with a s-phase of 12%, HER2 neg/ ER positive.  Now after feeling fine i had the tumor markers done on routine follow up (and then repeated them) that are slightly elevated (not quite double the normal value(of 38);  51 and then 69 repeated one month later) and my doctor is very strongly encouraging cat scanning my entire body.  She doesn't think it is a good idea to just repeat the markers in a few months to see if they are significant and are rising. I find this a bit too extreme...I doubt anything would show up on the scans anyhow at this stage.  And the markers aren't in a 'danger range' at all. Is she being overly conservative?  Would it be unreasonable to forego the scans at this stage of my disease?  I really am not worried at all, just aggravated. Thanks for any input on the matter.

CorkyP · Answer

I am a 56 year old whom had a .4cm aggressive, noninvasive, insitu tumor of the left breast diagnosed March 2001.  Underwent complete mastectomy with fourteen lymph nodes taken and all tested negative.  I underwent seven weeks of radiation and began Tamoxifen.  Tumor Marker 27.29 tests were taken after radiation October 2001.  The first one was 49.7; two months later 44; three months later 35.8; four months later 46; one month later 62; and then this last month 92!  I have had a CT Scan, Bone Scan, complete physical w/blood work up; now a complete PET Scan; all which are negative.  I have Irritable Bowel Syndrome, Diviticular Disease, and a small "normal" cyst in the liver.  My oncologist changed me from Tamoxifen to Arimidex which I will begin this week.  He is at a loss as to what is causing this rise in the marker test.  As he and my internist tell me, we are playing a waiting game.  My anxiety level is extremely high and although I have been told I have 95% good report, the other 5% is what is causing the anxiety............any suggestions?

omacar · Answer

had radical mastetomy 11-95.  Late 2001  27-29  hovered in 60s  and I had every  cat scan  a pet scan  and mri which showed nothing  tests completed in march 2002.  In june marker down to 57. Now in september it is 75 and the doc wants another whole work up.  I did have bone scan and chest  xray  which were negative. He put me on arimidex in Dec 2001.  I don't want to stick my head in sand here  but am refusing further testing at this time because I am having knee replacements next week.  I went for another opinion  and the thot was  why arimidex  when no evidence of disease.  Also felt the marker should have been repeated before anothe million dollar work  up.   I am confused at this point.  I will be 7 years next month.  Had chemo  and 2 positive nodes.  Have there been any medications that could affect marker?  I feel fine.

CCF-RN,MSN-JS · Answer

Dear gailgail, CA27.29 is a nonspecific marker for breast cancer. The use of CA27.29 to detect breast cancer recurrence at present is controversial. Increased levels could be due to a variety of reasons such as - ovarian cysts, uterine fibroids, intestinal or colonic problems, medication; Paxil, hepatitis, tuberculosis, systemic lupus. So these results need to be put in perspective of what is happening overall with you, conclusions can't be drawn from this single test alone. I don't know if there is something additional in your case that is adding to your physician's concern, but it does not seem unreasonable to wait.

tumor markers and need for further testing

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