Breast cancer tumor markers are substances produced by the body in reaction to a tumor or by the tumor itself. Testing for these markers can guide diagnosis, treatment, and predict prognosis. Different markers indicate different stages of tumor progression. Testing depends on the stage of cancer, and follow-up visits are recommended after treatment.
Breast cancer tumor markers are substances, usually proteins or hormones, produced by the body in reaction to a tumor or by the tumor itself. They are found in blood, urine or tissue or in tumor tissue. Different markers indicate different stages of tumor progression and growth and can be used to guide diagnosis and treatment, and to predict prognosis.
The first stage of breast cancer detection is mammography, ultrasound or breast magnetic resonance imaging (MRI), all of which are sensitive enough to detect breast cancer before symptoms are noticed. If there are any suspicious signs, a biopsy is taken and only then tests for breast cancer markers are administered. Testing alone isn’t enough, because the proteins and hormones they detect are sometimes made in the body by other conditions.
Before breast cancer treatment begins, a tumor marker test is given to establish baseline levels against which to compare subsequent results. While not tumor marker tests as such, estrogen receptors and progesterone receptors are measured to determine the type of cancer. Then the presence of human epidural growth factor 2 is determined, because this is a protein present in almost half of the patients who have breast cancer.
In order to establish the type of breast cancer and the best possible course of treatment, the first marker test is likely to be the urokinase plasminogen activator and plasminogen activator inhibitor test. Urikinase is an enzyme found in blood plasma and urine normally produced by the kidneys but can also be produced by tumors. This is a prognostic test, because high levels of urokinase plasminogen activator and plasminogen activator inhibitor usually indicate that the cancer has become more aggressive.
Testing for breast cancer tumor markers depends on the different stages of the cancer. Some tumor markers of breast cancer, such as carcinoembryonic antigen, cancer antigen 27.29, and cancer antigen 15-3, are indicative of breast cancer that has metastasized. Oncotype DX is a genetic test that helps determine the likelihood of breast cancer coming back. The ki-67 leveling index is another indication of how fast the cancer cells are proliferating and therefore how aggressive the cancer is. This tumor marker test measures the activity of the ki-67 antigen, a nuclear protein present during active cell phases but absent in resting cells.
A decrease in tumor marker levels from baseline is a good indication that the cancer is responding to treatment, and an increase in levels usually means that therapy needs to be changed. At the end of a treatment phase or during any follow-up treatments, tests for breast cancer markers may be needed to monitor for any recurrence. Follow-up visits are recommended after four to six months.
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