Serial CEA and CA 15-3 measurements during follow-up of breast cancer patients.
OBJECTIVE
CEA and CA 15-3 are adequate parameters for the early diagnosis of metastases in breast cancer patients. During the last years serial marker measurements have been discussed controversely and moreover accused of frightening breast cancer patients in the sense of a tumor marker terror. Therefore we evaluated the acceptance and practicability of an intense follow-up program including monthly measurements of CEA and CA 15-3.


METHODS
Between 1985 and 1995. 547 breast cancer patients were asked to give blood samples every four weeks for CEA and CA 15-3 measurements. In a field research study using a half-standardized interview by telephone we evaluated the acceptance of serial marker measurements in defined aspects: personal acceptance, blood sampling intervals, form of information, role of the home practitioner, motivation.


RESULTS
280 patients could be analyzed for the acceptance of this follow-up program. 52% of this patient group accepted serial tumor marker measurements, while 48% did not. 99% of the participating patients agreed to monthly blood sampling intervals compared to only 41% of the non-participating patients. 64% of the analyzed patients would have preferred both written and personal information about the role of CEA and CA 15-3 and this kind of follow-up program. Only in 6% of the participating patients the home practitioner had a negative attitude towards monthly tumor marker measurements compared to 36% in non-participating patients. Moreover serial marker measurements led to a feeling of security and reassurance in 85% of the patients.


CONCLUSIONS
CEA and CA 15-3 measurements are adequate and accepted instruments for the follow-up and early diagnosis of metastases in breast cancer patients. If patients got detailed information and support from their home practitioner, serial CEA and CA 15-3 measurements could lead to a feeling of security in most of the patients.
Jäger
W
W
Department of Obstetrics and Gynecology, Friedrich Alexander University, Universitätsstrasse 21-23, D-91054, Erlangen, Germany. wolfram.jaeger@frauen.med.uni-erlangen.de
Eibner
K
K
Löffler
B
B
Gleixner
S
S
Krämer
S
S
D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood* / Q000175:diagnosis; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018396:Mucin-1 / Q000097:blood*; D011182:Postoperative Care; D011379:Prognosis
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1