Abstract
The measurement of circulating tumour markers (TMs) for the diagnosis or monitoring of breast cancer has sometimes been considered of limited utility. In addition to the overinterpretation of irrelevant changes in marker levels, the characteristics of the patient, the disease or other pathologies that can modify them are often not considered in their evaluation. On the other hand, there are recent data on the relationship of TMs with molecular subtypes and on their prognostic value, the knowledge of which may improve their clinical utility. This consensus article arises from a collaboration between the Spanish Society of Laboratory Medicine (SEQCML) and the Spanish Society of Medical Oncology (SEOM). It aims to improve the use and interpretation of circulating TMs in breast cancer. The text summarizes the current knowledge and available evidence on the subject and proposes a series of recommendations mainly focussed on the indication, the frequency of testing and the factors that should be considered for correctly interpreting changes in the levels of TMs.
Highlights
Breast cancer is the neoplasm with the highest incidence in women in Spain [1]
The Spanish Society of Laboratory Medicine (SEQCML) and the Spanish Society of Medical Oncology (SEOM) have formed a joint working group to develop recommendations that are applicable in today’s clinical environment and that will be useful for daily medical practice
The relevance of breast cancer as the leading neoplasia in women and the complexity of its treatment approach have motivated the writing of this consensus article, which aims to improve the use and interpretation of circulating tumour markers (TMs) in patients with breast cancer
Summary
Breast cancer is the neoplasm with the highest incidence in women in Spain [1]. in recent years its prognosis has improved considerably and new treatments and diagnostic tests have been rapidly developed, the evaluation of circulating tumour markers (TMs) for the diagnosis or monitoring of this neoplasia is considered to have limited utility, to the point that they are included in the “do not use” recommendations [2, 3]. When the degree of disease involvement could not be quantified, a significant increase in levels of mucins (CA15.3 and BR27.29) or CEA in the absence of an increase in mucins according to the established progression criteria may indicate the ineffectiveness of the treatment and the need to consider discontinuing it [29] This concept is supported, with small variations, by the main clinical practice guidelines. As a general recommendation of this consensus document, and considering routine clinical practice and the recommendations of most clinical practice guidelines, the usefulness of TMs for treatment monitoring in patients with advanced breast cancer who have elevated baseline levels should be noted, especially when the disease is difficult to evaluate by imaging.
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