[Is follow-up of breast cancer with CEA and CA 15-3 justified?]

The significance of the tumor markers CEA and CA 15-3 for the oncological follow-up of breast cancer was examined in a retrospective analysis of 274 patients. Only 45% of 225 patients with nonmetastatic breast cancer showed in a period of 3 years normal values for both markers. 123 patients with increased markers in the same period were without evidence of tumor progression. Neither marker is suitable for the diagnosis of a local recurrence. In 32 cases of distant metastasis CA 15-3 is more sensitive than CEA (88%/63%), with an increase of 3% in sensitivity when analysing both markers simultaneously. The cut off level of CA 15-3 is problematic, 25 U/ml or 40 U/ml can be used as a threshold for tumoral activity. The use of tumor markers in the follow-up is not really justified so long as the prognosis or mortality of a patient is not changed by starting therapy early.