Tumour marker measurements in the diagnosis and monitoring of breast cancer

Elevation of established blood tumour markers correlates with the stage of breast cancer. The major role of current blood markers is therefore in the diagnosis and monitoring of metastatic disease. A combination of markers is better than a single marker with the most widely adopted combination being CEA and one MUCI mucin, commonly detected as either CA15.3 or CA27.29. Tum our marker measurement is now used as a complementary test in the diagnosis of symptomatic metastases. in the monitoring of therapeutic response to bo th endocrine and cytotoxic therapies in advanced disease, biochemical asses sment using blood markers not only correlates with conventional UICC criter ia but has a lot of advantages which make it a potentially superior way of assessment. In this regard, CA15.3, CEA and ESR are the best validated comb ination. Studies are ongoing to evaluate the use of sequential blood tumour marker m easurements in the follow-up of patients after treatment for their primary breast cancer in terms of both early detection and early therapeutic interv ention. Further randomized studies are also required to ascertain that mark er-directed therapy is superior to the current practice for metastatic dise ase. in line with clinical studies, intensive laboratory work is being carr ied out to optimize the use of blood markers in advanced disease as well as to exploit their use in screening and diagnosis of early primary breast ca ncer. (C) 2000 Harcourt Publishers Ltd.