CA 15-3 and bone scintigraphy in the follow-up of breast cancer.
By means of the retrospective study of the clinical records of 158 women followed for breast cancer, we aimed to evaluate the consequences of a non-systematic indication for bone scan (BS) based either on CA 15-3 levels alone or a combination of tumor marker levels and clinical criteria. With the first option, the negative predictive value was 95% and 82% of the BS would have been avoided. With the second option, the negative predictive value was 97% and 59% of the BS would have been avoided. Furthermore, the preliminary results of a longitudinal study showed that those patients with normal CA 15-3 levels and positive bone scans showed a subsequent rise in CA 15-3 levels which frequently became elevated with a average delay of 15 months. Omission of systematic bone scans in the follow-up of breast cancer patients is likely to lead to a delay in the diagnosis of bone metastasis in 3% to 5%, the consequences of which have to be examined carefully.
Younsi
N
N
Service de Médecine Nucléaire, Hôpital Tenon, Paris, France.
Montravers
F
F
Philippe
C
C
Seddiki
M
M
Uzan
S
S
Izrael
V
V
Talbot
J N
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000097:blood* / Q000473:pathology; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002277:Carcinoma / Q000097:blood* / Q000556:secondary; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D009363:Neoplasm Proteins / Q000097:blood*; D009367:Neoplasm Staging; D010146:Pain / Q000209:etiology; D011237:Predictive Value of Tests; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D009363:Neoplasm Proteins