Tumour markers--magic or menace?

Breast cancer follow-up is aimed at the detection of metastatic disease at a stage when it can still be treated. Traditionally this has been done on a symptomatic basis confirmed by UICC criteria. By inference, tumour burden by this time is likely to be high, and therefore any therapy possibly less effective. Breast Serum Tumour Marker estimation, while disease volume is still low, has been shown in a District General Hospital setting to allow early treatment and monitor efficacy of therapy. A randomised multi-centre study is essential to determine whether these investigations are sensible and life-saving or costly and confusing.