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I found this information, by Dr. Susan Love (a noted breast cancer specialist). Not sure if it helps, but.....

"Since it is not highly sensitive or specific, the CA 27.29 test can go up for reasons other than metastasis, resulting in false positives, and it may not go up when there is metastasis, resulting in false negatives. The CA 27.29 test has been proven to be helpful, however, in following increases in metastasis in women who have already been found to have metastatic disease, allowing doctors to better adjust treatment regimens.

In addition to having the CA 27.29 test, your oncologist may recommend that you have the CEA and CA 15-3 tumor marker tests done as well. These are not highly sensitive or specific either. If you choose to have any of these tests done it should be with the knowledge that there is currently no test or scan that can reliably tell us whether a small number of breast cancer cells have gotten into, and have begun growing in, other parts of the body, and that information you receive may not be accurate.

There is a series of tests that can help find large amounts of cancer cells in other parts of the body. These are called staging tests (this is not the same as the stages of breast cancer), and include chest X-rays, which can find cancer in the lungs, blood tests that can determine if the cancer has spread to the liver, and bone scans, which can help ascertain if the cancer has spread to the bone. CAT scans are also used to detect spread of cancer to liver, lungs, a certain area of bone, or even your brain. Like the blood tests, though, these tests are not good at finding small numbers of cancer cells.

Should you have the CA 27.29 test done? The American Society of Clinical Oncology recommends against routine testing of markers after a breast cancer diagnosis. Some oncologists recommend that women have this test every three to six months with the hope that they will find metastasis early. The problem is that there is no evidence that finding metastates by a blood test before a woman has symptoms will improve her survival or quality of life. The treatment of metastatic disease is aimed at reducing symptoms (breast cancer is not curable once it is metastatic) and putting the woman into remission. It is hard to improve symptoms if a woman does not have any. Most women whose breast cancer has metastasized do not show any symptoms until the disease is quite extensive. Symptoms of metastatic disease include bone pain, shortness of breath, lack of appetite and weight loss, and neurological symptoms like pain or weakness or headaches.

Ultimately, the only way to determine whether having routine CA 27.29 testing is right for you is to think about how you want to handle the aftermath of your breast cancer treatment and whether a test that has limitations will be helpful for you. Some women find reassurance in having the CA 27.29 test done and getting a negative result, even if it is not a guarantee that nothing is going on. Others find the thought of having the test stressful and choose to not have it done. There is no "right" choice. Until we have new, better tests that are highly sensitive and specific, women will need to decide for themselves whether testing is right for them."

Incidentally, when my mother's breast cancer was VERY advanced, her tumor markers were still very obviously these tests are far from perfect. I think the markers are used as guidelines and can indicate if further testing is needed (like CT scans, PET scans, specialized mammograms, etc.). I would discuss it with your doctor.



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