What are the malignant causes of elevated CA 27-29 levels?

Updated: Jul 11, 2019
  • Author: Nikhil G Thaker, MD; Chief Editor: Eric B Staros, MD  more...
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Malignant causes of elevated CA 27-29 levels are as follows:

Generally, the higher the CA 27-29 level, the more advanced the breast cancer or larger the tumor burden. [4] If the tumor produces CA 27-29, then tumor marker levels tend to increase as the tumor grows. The highest levels may be seen in metastatic breast cancer, particularly with metastases to the liver or the bones. However, CA 27-29 can be low or absent in all of these settings since not all breast cancers produce CA 27-29, or it may be too early in the disease process to detect CA 27-29 levels. Normal levels, therefore, do not ensure absence of localized or metastatic disease.

CA 27-29 levels, in conjunction with the history, physical examination, and diagnostic imaging findings, are typically used to monitor treatment response of metastatic breast cancer. A decrease in CA 27-29 levels can indicate tumor response or regression of disease. Stable or increasing CA 27-29 levels, despite adequate treatment, can indicate tumor nonresponsiveness or tumor recurrence.

CA 27-29 levels can also be serially obtained after treatment of metastatic breast cancer. In the absence of measurable disease, an increase in CA 27-29 levels could indicate treatment failure. A transient rise in CA 27-29 levels can occur during the first 4-6 weeks of starting therapy; [5] however, this does not usually correlate with disease progression and should be interpreted with caution.

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