Biochemical markers in breast cancer: which ones are clinically useful?

Breast cancer is the most common neoplasm affecting women in the Western wo rld with approximately 1 in 11 developing the malignancy and 1 in 30 dying from the disease. For optimum management of these patients, assay of certai n biochemical markers is necessary. Clinically, the most useful markers in breast cancer are the estrogen and progesterone receptors that are used to predict response to hormone therapy. Both American and European Expert Pane ls have recommended routine determination of these steroid hormone receptor s in all patients with breast cancer. For surveillance of patients with dia gnosed breast cancer, both CA 15-3 and BR 27.29 can be used. Serial determi nations of these markers have the potential to preclinically detect recurre nt disease and monitor the treatment of advanced disease. However, the bene fit of this monitoring on patient outcome or quality of life is not clear. New or potentially new markers for breast cancer include BRCA1 and BRCA2 fo r selecting patients at high risk of developing breast cancer, urokinase pl asminogen activator and PA1-1 for assessing prognosis and HER-2 for predict ing response to the therapeutic antibody, Herceptin. (C) 2001 The Canadian Society of Clinical Chemists. All rights reserved.