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Which tumour markers are used to follow up breast cancer patients?

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Practicing since : 2004
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Breast cancer stage 2a, node negative, 2.4 cm, no lymphovascular invasion, bilat/mastec. ER+ Her2 +++. First PET scan negative 8 months ago, brain MRI and liver ultrasound ok 6 months ago.My question is about tumor markers:
Preoperative CEA was only .7 (UNL 5ng/ml supposedly for smokers, I do not smoke)), and ca-15.3 was 5.4 (unl 32)
I finished chemo TCH 2 months ago but continue on herceptin and started tamoxifen 2 weeks ago.
My CEA was 1.3 in january, 1.1 april, 1.0 mid may and then in 6 weeks move to 2.7 and 3.7 yesterday. Ca 15.3 moved from 5.4 preop to 9 (still way below upper limit) >My onco is not worried but ordered second PET because it has been 8 months already. I'm very worried that CEA was lower when I had the tumor inside than now. Is it possible to see this just finishing chemo and why?, all my lab tests are now normal including liver enzymes which went up after multiple antibiotics (45 days of levaquin due to infection from chemo in December) and chemo but it was early in the year. I'm a mess because of possible relapse during per this CEA and after chemo/herceptin. Can chemo have delayed effects on CEA 2 months later? can tamoxifen do this in 2 weeks? 3 points since preop is too much for me. please help
Posted Sat, 14 Apr 2012 in Breast Cancer
Answered by Dr. Indranil Ghosh 33 hours later

Thank you for posting your query here.

I understand your concern. So I have a few statements to make, hope they answer all your queries-

1. You have an early stage disease and you are receiving appropriate treatment. Most likely you will do very well.

2. CEA and CA 15.3 are NOT used to follow-up breast cancer patients after adjuvant treatment. This is according to NCCN and all other guidelines. So you need not be much concerned with the results.

3. But as for the rise in CEA and CA 15-3, they are well within acceptable limits and you can stop worrying about those.

4. PET scan is also not recommended for routine follow-up and more so for a node-negative early breast cancer. You can do without these investigations as well.

Hope my answer is both informative and adequate. If you have any more concern, I am available for follow ups.

Best Wishes.

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