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Increased CEA level, have nodes at thyroid, taking Tamoxifen. History of breast cancer. Why is this happening?

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46years old woman treated for breast cancer. After surgery and before chemotherapy my CEA was 1,2. After 5 months after end of chemoteraphy and 2 months after radiotherapy my CEA raised up to 6,76 (normal limit is 5). CA 15,3 is normal, TPA is normal. I am following tamoxifen treatment because of the hormones positive.

I have also two small nodes at tyroidhe but my levels of FT3 and FT4 are normal. I do not smoke. Why the CEA level is rising?
Posted Tue, 25 Sep 2012 in Breast Cancer
Answered by Dr. Pavan Kumar Gupta 1 hour later
Thanks for the query.
The CEA test measures the level of protein in a blood sample of people with certain types of cancers.  The normal carcinoembryonic antigen range for a non smoking adult is < 2.5 ng/ml and <5.0 ng /ml for a smoking individual. A very high CEA level (above 20 ng/ml) is an indication of highly spread cancer.

CEA tests are mainly used to measure the success of cancer surgery. An elevated CEA level is likely to fall to normal after a successful surgery. Rising CEA levels is an indication of progressing or recurrence of cancer. CEA tests are also indicative of how well the treatment is working. CEA tests are most beneficial in gauging the success of medications and therapies.
However  Radiation therapy and chemotherapy can also cause a temporary rise in  CEA levels 

However there is no consensus among oncologists as to the appropriate and optimal follow-up for long-term breast cancer survivors.  The 2007 ASCO guidelines do not support the use of tumor biomarkers, including CEA, CA15.3, and CA27.29, for monitoring patients for recurrence after primary breast cancer therapy.
Women who have had surgery for breast cancer may still require breast cancer screening with mammography. If a woman had a total mastectomy, then the other breast requires yearly follow-up, because she is still at higher risk of developing cancer in the remaining breast. If she had subcutaneous mastectomy, partial mastectomy, or lumpectomy, then that breast itself requires follow-up mammography.
Tumor markers, such as CEA, CA15.3, and CA27.29, can be used in conjunction with diagnostic imaging, history, and physical examination for monitoring while on active therapy. CA15.3 and CA27.29 levels correlate with the course of disease in 60-70% of patients, whereas CEA levels correlate in 40% of patients.

However, data are insufficient to recommend the use of CEA, CA15.3, or CA27.29 alone for monitoring response to treatment. Caution should be used when interpreting rising CEA, CA15.3, or CA27.29 levels during the first 4-6 weeks of a new therapy, as spurious early rises may occur.

Since your CEA is increased and CA 15.3 is normal,it can't be said with surety whether this rise is a false rise or due to spread.You require more investigations for knowing the exact cause.
I recommend you to have consultation and discussion with your treating surgeon and oncologist.

I hope my answer satisfies you however you may revert to me for any follow up query.If there is nothing to ask more,you may kindly rate my answer and close this query.
Best of luck
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