INCREASING SERUM LEVELS OF MUCIN-LIKE CARCINOMA-ASSOCIATED ANTIGEN AND MUCINOUS ANTIGEN-H23 IN CLINICALLY DISEASE-FREE BREAST-CANCER PATIENTS

The role of MCA in early detection of relapsing breast cancer was asse ssed in 51 patients on follow-up. All were symptom and disease free, b ut had gradually increasing serum levels of MCA in at least two consec utive measurements. Thirteen patients (25.4%) had already developed ov ert metastatic disease in only one site. The lead time between the fir st measurement of elevated MCA and the diagnosis of relapsing disease in the group of 13 patients ranged from 31 to 200 weeks (median 78). M CA level at the end of the lead period ranged from 16.88 to 205 U/ml. CEA was elevated in only 7/51 patients (13.7%) on follow-up, and in on ly 2/13 patients (15.4 %) with elevated MCA who developed overt diseas e. H23 was elevated in 11 out of the 13 relapsing patients with high M CA level. Corresponding H23 levels at the end of the MCA-based lead pe riod ranged from 0.246 to 2.0 OD. The dilemma of 'treat' versus 'wait and see' arises whenever increasing levels of MCA are detected in asym ptomatic disease-free patients. It is assumed that early treatment may delay the appearance of overt disease.