the Significance of CA15-3 in Breast Cancer Screening

The CA15-3 marker is a tumor marker used in the blood test for breast cancer. It is primarily utilized to monitor treatment response and disease progression in patients already diagnosed with breast cancer, rather than for initial screening or diagnosis. Elevated levels of CA15-3 may indicate the presence of breast cancer or its recurrence, but it is not specific to breast cancer alone and can be elevated

Hello Dr.
Zhao, I would like to ask about the significance of the breast cancer blood marker CA15-3.
If this marker is normal, does that mean there is no need for breast ultrasound or mammography? Since this marker is included in my annual health check-ups, I would like to understand its significance and how it differs from breast ultrasound.
Additionally, I had a unilateral fibroid removed at the age of 20, and at that time, both breasts had fibroids, but the doctor recommended removing one side for biopsy, which resulted in a benign fibroid.
Until two years ago, my health check-up report still indicated "low echo irregular nodules," while the CA15-3 marker was normal.
When I asked the doctor about the nodules, he said there was no need to worry.
I would also like to ask you, Dr.
Zhao, what does "nodules" mean? Should I continue to have regular ultrasound follow-ups, or is it sufficient to monitor as long as the CA15-3 marker is normal? Thank you for taking the time to answer!

Sharon, 30~39 year old female. Ask Date: 2006/11/06

Dr. Zhao Ming reply Breast and Thyroid

CA 15-3 is recommended for breast cancer screening, as the majority of newly diagnosed breast cancer cases have normal CA 15-3 levels.
Early detection of breast cancer relies on regular breast examinations (clinical breast exams), mammography, and ultrasound, which provide the opportunity for early identification of breast cancer.
Dr.
Zhao Ming.

Reply Date: 2006/11/06

More Info

CA15-3 is a tumor marker that is primarily used in the monitoring of breast cancer, particularly in patients who have already been diagnosed with the disease. It is important to understand that while CA15-3 can provide valuable information regarding the presence of breast cancer, it is not a definitive screening tool for early detection. The significance of CA15-3 lies in its ability to indicate the presence of cancer cells in the body, but it is not used as a standalone diagnostic tool.
In clinical practice, CA15-3 levels can be elevated in various conditions, not just breast cancer. For instance, benign breast diseases, liver diseases, and even during pregnancy can lead to increased levels of CA15-3. Therefore, a normal CA15-3 level does not necessarily mean that breast cancer is absent, nor does it eliminate the need for regular breast examinations, including mammograms and ultrasounds.
Mammography and breast ultrasound are essential tools for the early detection of breast cancer. Mammograms can identify abnormalities in breast tissue that may not be palpable during a physical examination, while ultrasounds can provide additional information about the characteristics of breast masses. These imaging modalities are crucial for detecting breast cancer at an early stage when it is most treatable.
Regarding your previous history of a benign fibroadenoma and the current findings of "low echo irregular nodules," it is essential to continue monitoring these changes through regular imaging. The term "nodule" refers to a small, rounded mass of tissue, which can be benign or malignant. The irregularity of the nodules may warrant further investigation, especially if there are changes over time.
Given your medical history and the presence of nodules, it is advisable to maintain regular follow-ups with your healthcare provider, including breast ultrasounds and mammograms, regardless of the CA15-3 levels. Regular monitoring can help ensure that any changes in your breast tissue are detected early, allowing for timely intervention if necessary.

In summary, while CA15-3 is a useful marker in the context of breast cancer management, it should not replace routine breast imaging and clinical examinations. Regular screenings are vital for early detection and management of breast cancer, especially for individuals with a history of breast abnormalities. It is always best to discuss your specific situation with your healthcare provider, who can tailor a monitoring plan based on your unique medical history and risk factors.

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