Tumour marker CA15-3: possible uses in the routine management of breast cancer.

Tumour markers are a potentially powerful means of obtaining information about cancers whilst causing minimal morbidity, inconvenience and cost. CA15-3 has been suggested as a marker of distant metastasis (M+ disease) in breast cancer. We have measured CA15-3 in 77 patients with carcinoma of the breast in order to determine whether routine assay of this tumour marker would be useful in the oncology unit of a district general hospital. A highly significant correlation existed between elevated CA15-3 levels (> or = 30 U/ml) and M+ disease. The CA15-3 assay was found to have a sensitivity of 70%, a specificity of 96% and a predictive value of 87%, in agreement with previous studies. There was evidence that CA15-3 levels frequently increased in advance of otherwise detectable distant metastases. 70 patients had a 99m Tc bone scan close to the date on which CA15-3 was measured. All patients with a positive bone scan and raised levels of CA15-3 were subsequently confirmed as having bony metastases; no patient with normal bone scan and normal CA15-3 developed M+ disease (to the date of follow-up). CA15-3 levels were raised in 83% of patients who developed non-bony distant metastases. In clinical practice it may be possible to exploit the high specificity of CA15-3, in order to provide additional information to that already determined by current investigations. For example, CA15-3 might be assayed alongside a bone scan to confirm positive or negative results. Another role might be as a screen for breast cancer metastases in departments with limited access to bone scans and other imaging facilities. CA15-3 might also be used in monitoring patients for the development of distant metastases during follow-up. It is, however, unlikely that CA15-3 can substitute directly for a bone scan or other imaging currently used routinely by a department. Clinical trials are now necessary to determine the effect of using tumour markers such as CA15-3 on patient morbidity and mortality.

[1]  Y. Mizuguchi,et al.  [CA 15-3 is present as a novel tumor marker in the sera of patients with breast cancer and other malignancies]. , 1985, Gan to kagaku ryoho. Cancer & chemotherapy.

[2]  S. Suzuki.  Early diagnosis for bone metastasis of breast cancer based on bone metabolism. , 1990, Fukushima journal of medical science.

[3]  W. Eiermann,et al.  Significance of Bone Alkaline Phosphatase, CA 15-3 and CEA in the Detection of Bone Metastases During the Follow-Up of Patients Suffering from Breast Carcinoma , 1992, European journal of clinical chemistry and clinical biochemistry : journal of the Forum of European Clinical Chemistry Societies.

[4]  J. Geraghty,et al.  CA 15‐3 in patients with locoregional and metastatic breast carcinoma , 1992, Cancer.

[5]  A. Howell,et al.  Assessment of four monoclonal antibodies as serum markers in breast cancer. , 1990, European journal of cancer.

[6]  G. Rustin,et al.  A Review of the Role of Established Tumour Markers , 1991, Annals of clinical biochemistry.

[7]  A. Nicolini,et al.  Evaluation of serum CA15-3 determination with CEA and TPA in the post-operative follow-up of breast cancer patients. , 1991, British Journal of Cancer.

[8]  E Ciambellotti,et al.  [Determination++ of CA 15-3 in the control of primary and metastatic breast carcinoma]. , 1993, Minerva medica.

[9]  S. Bates,et al.  Clinical applications of serum tumor markers. , 1991, Annals of internal medicine.

[10]  H. Grimes,et al.  CA15-3: a reliable indicator of metastatic bone disease in breast cancer patients. , 1992, Annals of the Royal College of Surgeons of England.

[11]  P. Günczler,et al.  Tumormarker bei Mammakarzinom: Zur diagnostischen Wertigkeit von Serumbestimmungen bei klinischer Tumorfreiheit (NED) und manifester Erkrankung , 1989 .