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Title: Guidelines Define Tumour Markers For Improved Breast Cancer Care

URL: http://www.john-libbey-eurotext.fr/articles/bdc/87/10/723-37/en-resum.htm

"Standards, Options and Recommendations (SOR) for tumor markers in breast cancer"
11/27/2000 07:56:00 AM
By David Loshak

A major long-term French project has developed new recommendations for breast cancer tumour marking to improve the management of patients with the disease. They come from the Standards, Options and Recommendations project launched by French cancer centres and specialists in 1993. The guidelines were derived from literature reviews and critical appraisal by experts in various disciplines with feedback from oncologists. They define the characteristics of different tumour markers in breast cancer and their potential role in patient management. They identify the mucin antigen CA 15.3 and carcinoembryonic antigen (CEA) as the serum tumour markers most often used in breast cancer. If the CA 15.3 is raised at presentation, the guidelines say, there is no place for the measurement of other tumour markers. All analyses for each patient must be performed in the same laboratory, using the same technique. CA 15.3 should not be used for screening. Although the CA 15.3 level before treatment is a recognised prognostic factor, its independent value has not been proven, the guidelines note. They indicate that if the initial value of CA 15.3 exceeds 50 kU.L-1, no treatment decisions should be made until disseminated disease has been actively sought. They also say that an initial elevation of CA 15.3 that does not return to normal reflects a lack of response to treatment -- it is a strongly adverse prognostic factor. The guidelines point out that although tumour markers, especially CA 15.3, are known to be accurate early indicators of metastatic disease, the clinical benefit has not been established. The recommendations also draw attention to a correlation between tumour markers and clinical response in treating metastatic disease. However, the level of CA 15.3 in metastatic disease does not predict response to treatment.

http://www.john-libbey-eurotext.fr/articles/bdc/87/10/723-37/en-resum.htm

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