CA 15-3 (Breast tumour marker)

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Cancer antigen 15-3 (CA 15-3) is a protein that is produced by normal breast cells. In many people with cancerous breast tumours, there is an increased production of CA 15-3 and the related cancer antigen 27.29. CA 15-3 does not cause cancer; rather, it is shed by the tumour cells and enters the blood. This test measures CA 15-3 in the blood.


Since CA 15-3 can be measured in the blood, it is useful as a tumour marker to follow the course of cancer. CA 15-3 is elevated in fewer than 50% of women with early localized, breast cancer or with a small tumour, but is elevated in about 80% of those with breast cancer that has spread (metastatic). Because not all women with invasive breast cancer will have elevated CA 15-3, the test is not useful in all cases.


CA 15-3 is not recommended as a screening test to detect breast cancer in women because it is non-specific. It may also be elevated in healthy people and in individuals with other cancers such as colon, lung, pancreas, ovarian, or prostate malignancies or certain conditions such as cirrhosis, hepatitis, and benign breast disease.

About

The cancer antigen 15-3 is used to monitor response to breast cancer treatment and disease recurrence. If you are diagnosed with breast cancer that has spread to other parts of the body (metastasized) you will likely be referred for this test. It is not often measured at the early stages of breast cancer as it is rarely higher than normal at this stage. In general the higher the CA15-3 the more cancer there is in the body. If the level of CA15-3 starts to fall it indicates the treatment is working.

Preparation

The CA 15-3 blood test involves a simple blood test that will be sent to a lab for testing. No preparation is needed beforehand.

Indications

  • Managing breast cancer patients when used in conjunction with clinical information and other diagnostic procedures
  • Serial testing can assist in early detection of disease recurrence in previously treated stage II and III breast cancer patients
  • Monitoring response to therapy in metastatic breast cancer patients
CA 15-3 may be ordered along with other tests when advanced breast cancer is first diagnosed to help determine cancer characteristics and treatment options. If CA 15-3 is initially elevated, then it may be ordered periodically to monitor the effectiveness of treatment and to help watch for recurrence. CA 15-3 is usually not ordered when breast cancer is detected early before it has spread (metastasized) because levels will not be elevated in the majority of early cancers.

Interpretation

In general, the higher the CA 15-3 level, the more advanced the breast cancer and the greater the amount of cancer present (tumour burden). CA 15-3 concentrations tend to increase as cancer grows. In metastatic breast cancer, the highest levels of CA 15-3 often are seen when cancer has spread to the bones and/or the liver.


Increasing concentrations of CA 15-3 over time may indicate that a person is not responding to treatment or that the cancer is recurring.


Normal CA 15-3 levels do not ensure that a person does not have localized or metastatic breast cancer. It may be too early in the disease process for elevated levels of CA 15-3 to be detected or the person may be one of the roughly 20% to 25% of individuals with advanced breast cancer whose tumours do not shed CA 15-3.


Mild to moderate elevations of CA 15-3 are seen in a variety of conditions, including cancer of the lung, pancreas, ovary, prostate, and colon as well as cirrhosis, hepatitis, and benign breast disorders and in a certain percentage of apparently healthy individuals. The CA 15-3 elevations seen in non-cancerous conditions tend to be stable over time.

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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