C2729 results & Bone Mets- little to no pain

[redmal]

I was diagnosed with stage III breast cancer in mid-Sept which was restaged to stage IV on Nov 1st when PET Scan revealed widespread bone mets (spine, pelvis, long bones of both arms and both legs), small chest wall mets and some remaining affected lymph nodes (following lumpectomy & axillary node dissection).  Being premenopausal or perimenopausal(?) -  I'm 46, but no symptoms of entering menopause) I was started on Tamoxifen (40 mg/day), Lupron 3 month injection and Aredia in November.  My last 2 blood tests (Nov 6, Dec 11) show rising tumor markers on the C2729 (I was normal before surgery at the end of Sept) in the C2729 test.  1st one was 58, next one was 79.  I had another blood test this week and am waiting for results still of the C2729 (E2 is at 12 and FSH and LH are very low).  Are these results considered high or just moderately elevated or ?  Do they  indicate the Tamoxifen and Lupron are not working, or is it too soon since treatment began to see an effect?  Also, despite the PET Scan showing widespread bone mets, I don't have any bone pain.  The only time I feel any sort of pain is in my left hip if I am leaning up against something hard - like the kitchen counter and only lasts for as long as I bump against the counter.  I'm told I'll know the bone pain when I have it, but I wonder if some people don't have bone pain until the bones are at a very advanced degree of being affected?
Thanks for any insight.

[Dennis MD]

Hi.
Cancer Antigen 27.29 is a tumor marker that can be used to monitor treatment, whether there is progression or not.  However, nonmalignant conditions can falsely elevate this type of marker.  Just like in other tumor markers, the result should be used in conjunction with clinical evaluation.
You may not be experiencing pain because you were given Aredia.  This drug can prevent bone pains, as well as relieve existing bone pains.
In order to find out if you have progressive disease or not, you need to undergo diagnostic evaluation like a repeat PET scan.
Do consult your oncologist regularly.
Good luck.

[redmal]

Thank you.  I guess my question on the C27.29 is more general in nature as to what may constitute a markedly high value versus moderately high.  I recognize that each individual case is different and am just trying to get a feel for where levels, in general, fall.  My oncologist is not too concerned about it yet (I see my oncologist monthly).
I wasn't experiencing bone pain prior to starting on Aredia, yet the widespread nature of the metastasis leads me to think that it's been there for a while, and still I didn't have any pain (the left hip is new, last two weeks).  I'm not scheduled for another PET scan for 4 more months, unless something changes clinically.