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Breast Cancer (Expert Forum)
Update on Monitoring Post Cancer Patients with CA27.29
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Update on Monitoring Post Cancer Patients with CA27.29
by BillyBob3312, Jan 28, 2003 12:00AM
The last entery I could find on this site having to do with the use of CA27.29 was dated 2001. My Mother-in-law is a 15 year survivor, was on Tomoxafin therapy for 6 or 7 years and has had no indication of recurrence. Her CA27.29 levels have been running 38-40 said to be at the upper limit of normal for a long time. In December she had a 52 and in January a 64. She is scheduled for a CT. Has the thinking changed on the usefulness of this marker as a monitoing device for recurrence since 2001? I am curious if there is more info on the potential non CA related causes of elevated levels. The first of January She had slightly elevated liver enzymes (don't know which one) but those have returned to normal range. Thank you in advance for your response.
Doctor's Answer
by CCF-RN,MSN-JS, Jan 28, 2003 12:00AM
Dear BillyBob3312, No there has been no change. I'm copying for you the answer from a January 16, 2003 question, which may have more information than the answer you saw.
The use of CA27.29 to detect breast cancer recurrence at present is controversial. When other alternative causes of elevated CA 27.29 have been eliminated, an abnormal test result may indicate recurrent disease. However, there has been no evidence to date that treatment based solely on CA27.29 elevation significantly improves overall survival rates. The American Society of Clinical Oncologists (last update in 1997) guidelines state that at present the data are insufficient to recommend routine use of CA27.29 for screening, diagnosis, staging or surveillance following primary treatment. Although an increasing CA 27.29 can detect recurrence following primary treatment, the clinical benefit is not established. When discussing clinical benefit they are talking about will this have an effect on disease free or overall survival? Will the benefit of early treatment outweigh the risks of treatment side effects? The answers or evidence in regards to these questions is not currently available.
Elevated levels may be found in-patients with other diseases such as ovarian cysts, uterine fibroids, intestinal or colonic problems, medication; Paxil, hepatitis, tuberculosis, systemic lupus.
Whether a person should proceed with treatment based solely on the elevated CA27.29 would have to be seriously weighed based on risks of treatment and unknown overall benefit. In most cases, a CA27.29 would not be sufficient information on which to base treatment decisions.
The use of CA27.29 to detect breast cancer recurrence at present is controversial. When other alternative causes of elevated CA 27.29 have been eliminated, an abnormal test result may indicate recurrent disease. However, there has been no evidence to date that treatment based solely on CA27.29 elevation significantly improves overall survival rates. The American Society of Clinical Oncologists (last update in 1997) guidelines state that at present the data are insufficient to recommend routine use of CA27.29 for screening, diagnosis, staging or surveillance following primary treatment. Although an increasing CA 27.29 can detect recurrence following primary treatment, the clinical benefit is not established. When discussing clinical benefit they are talking about will this have an effect on disease free or overall survival? Will the benefit of early treatment outweigh the risks of treatment side effects? The answers or evidence in regards to these questions is not currently available.
Elevated levels may be found in-patients with other diseases such as ovarian cysts, uterine fibroids, intestinal or colonic problems, medication; Paxil, hepatitis, tuberculosis, systemic lupus.
Whether a person should proceed with treatment based solely on the elevated CA27.29 would have to be seriously weighed based on risks of treatment and unknown overall benefit. In most cases, a CA27.29 would not be sufficient information on which to base treatment decisions.
