Tumor markers of breast cancer
introduction
In the meantime, “tumor marker” has become a common term when it comes to cancer. Nevertheless, very few people know exactly what the term means. A tumor marker is a certain molecule that can usually be measured by a blood test and that indicates the presence of a tumor (e.g. breast cancer, colon cancer, prostate cancer). The first occurrence or an increase in normal values should then indicate a specific cancer.
Read more on this topic at: Tumor markers
Tumor markers in breast cancer
For breast cancer, the most interesting tumor marker is CA 15-3 (cancer antigen). In breast and ovarian cancer, increased levels of this protein molecule can be measured. But other diseases can also lead to an increase in the CA 15-3 values, e.g. hepatitis (inflammation of the liver), pancreatitis (inflammation of the pancreas) and various inflammatory diseases of the lungs and gastrointestinal tract.
In the case of breast cancer, the level of the measured values is quite well related to the disease activity, e.g. Assess whether chemotherapy is working or not.
Read more on this topic at: Breast cancer chemotherapy
In some cases, benign breast diseases can also be differentiated from malignant diseases using the CA 15-3 values. However, according to the guidelines of various research societies, the CA 15-3 determination is generally reserved for patients who have breast cancer that has already metastasized.
Read more on this topic at: Benign breast tumors
Here again at a glance:
Recommendations for early cancer detection
- What: Breast self-examination through observation and careful palpation
When: At any age
How often: Once a month (possibly 10 days after the end of the last menstrual period) - What: Visit the gynecologist
When: At any age
How often: Once a year - What: Performing an X-ray mammography as a preventive examination, possibly in combination with sonography or magnetic resonance mammography
When: Without risk factors between 50 and 69 years of age. From the age of 35 if there is a corresponding accumulation of risk factors (e.g. family stress), annual preventive measures
How often: In a 1-2 year interval
Read more on this topic at: Breast cancer screening
Values in numbers
Standard values:
- CA 15-3: <28 units / ml
- CEA (carcinoembryonic antigen): <5 ng / ml
It should be mentioned here, however, that there is a certain gray area in all tumor markers. A higher value does not automatically mean that you are suffering from a tumor disease. Elevated values can also occur in benign diseases.
How likely do I have breast cancer if the tumor marker is elevated?
No tumor marker is tumor specific. Increased concentrations can also be detected in healthy individuals. They are important when the early detection of a relapse or progression of a patient's tumor offers a benefit for quality of life or life expectancy. Pure values are not solely indicative. The overall picture of the patient is important. A gray area of CA 15-3 applies to values between 25-35 IU / ml. Above 35 IU / ml it would be suspect. It is similar with CEA. Values between 5-10ng / ml are in the gray area. Above 35 IU / ml it has a disease value. Despite these values, it is not possible to tell a patient 100% whether he has a tumor or not. This can only be demonstrated after further apparatus-based investigations.
The following topic could also be of interest to you: BRCA mutation
Are there tumor markers for bone metastases?
There are markers that provide an indication of bone metabolism. These include deoxypyridinoline, which is a very specific marker for bone resorption and thus for the activity of osteoclasts. There is also pyrodinoline, but this does not have the specificity of deoxypirodinoline. Another marker is bone phosphatase, also known as ostasis. It belongs to alkaline phosphatase, which is contained in many metabolic pathways in the body. This marker is also significantly increased during bone loss. Among other things, it is removed and examined if bone metastases are suspected.
In medicine, however, it is important not only to orientate oneself on laboratory values. Bone or skeletal scintigraphy provides a more precise indication of bone metastases. This is a method of displaying the metabolic activity of the bone. Here the patient receives a radioactive substance that accumulates in particularly active areas of the bone.
Read more on this topic at: Metastasis in breast cancer
What role do tumor markers play in follow-up care?
The follow-up examination is not schematized, but carried out individually. A detailed discussion with the patient takes place at every examination. Next, the patient is physically examined. Every six months, a gynecological cell examination and, if necessary, an ultrasound examination of the ovaries is carried out. Breast-conserving surgery also includes mammography. Every 12 months, a mammography and ultrasound examination of the other breast and an ultrasound of the armpit (lymph nodes) are recommended. Further examinations would only be carried out if metastases were suspected, e.g. X-ray of the chest, ultrasound of the liver, skeletal examination. Tumor markers are not a routine test. The markers are not checked routinely, but only in the event of suspicion or physical evidence.
Read more on this topic at: Follow-up care for breast cancer
Info: tumor markers
For a long time, much hope was placed in the discovery of tumor markers. You should be able to diagnose different types of cancer with a simple blood test. That would have meant lower costs and less stress for the patient. Unfortunately, these expectations have not been met. Tumor markers are becoming less and less important in the diagnosis of cancer.
Function of tumor markers
With a few exceptions, tumor markers are mainly used today for therapy and progress monitoring, and less for diagnosis. On the basis of the tendency with which the measured values develop, e.g. make a statement about the success of a therapy. The statutory program for the early detection of cancer therefore does not contain any tumor marker provisions.
Tumor marker problems
Ideally, a tumor marker should only be elevated or even measurable in the blood if a certain cancer is present. In reality, with a few exceptions, there is hardly a molecule that is specific for a type of cancer. This means that different types of cancer can affect the same tumor marker. However, other diseases and completely harmless causes can also influence the measured values in many cases. E.g. a simple bike ride can drive up the PSA value (tumor marker for prostate cancer) without a disease being present. Conversely, it can happen that the values remain in the normal range despite an illness.
