Tumor Markers:- Part 9 – CA 15-3 , CA 27-29 (Cancer Antigen 15-3 and 27-29)
Tumor Markers
CA 15-3 and CA 27-29, Tumor markers for breast cancer
What sample is needed for Tumor Markers?
- Venous blood is needed to prepare the serum.
- Citrated plasma can be used.
- < 5 days can be stored at 2 to 8 °C.
- If it takes more than 5 days, then store at -20 °C.
What are the Indications for Tumor Markers?
- These tumor markers (CA 15-3 and CA 27-29) are used to monitor the treatment of breast cancer.
- CA 27-29 is similar to CA 15-3.
- FDA approved along with CA 15-3 and CA 27-29 to monitor recurrences of stage II and Stage III breast cancer.
How will you discuss the pathophysiology of CA 15-3 and CA 27-29?
- This is also known as the cancer antigen breast.
- CA 15-3 is a glycoprotein, 400 KD, and membrane-enriched breast cancer extract.
- CA 27-29 is a high molecular weight glycoprotein.
- CA 15-3 and CA 27-29 are the markers for breast cancer.
- These are not as sensitive as other breast tumor markers.
- The raised level of CA 15-3 indicates advanced breast cancer or bulky tumor.
- Only 50% of the patients show highly localized breast cancer or a small tumor.
- However, 80% of the patients with metastatic cancer show a high level of CA 15-3, and 65% have CA 27-29.
- Other causes of the raised level of CA 15-3 and CA 27-29 are:
- Benign breast diseases.
- Cancers of the lung, pancreas, ovary, and prostate.
- These markers are good markers for the treatment of metastatic breast cancer.
- Remission will show a decreasing level.
- Persistently raised levels indicate progressive disease.
- CA 15-3 was the first tumor marker of breast cancer.
- These are not used for the screening of breast cancer.
- Most useful following the therapy response in metastatic breast cancers.
Tumor markers: CA 15-3 use
What is the normal CA 15-3 and CA 27-29?
- CA 15-3 = <31 U/mL or <31 k units /L.
- CA 27-29 = <38 U/mL or <38 k units /L.
- In healthy subjects, the upper limit is 25 kU/L.
- 5.5% of the normal subjects.
- 23% of the primary breast disease.
- 69% with metastasis to the liver.
- In healthy subjects, the upper limit is 25 kU/L.
- Source 2
- CA 15-3 = <22 units/mL (<22 kU/L).
- CA 27-29 = <38 units/mL (<38 kU/L).
What causes the raised levels of tumor markers (CA 15-3 and CA 27-29)?
- Metastatic breast cancer.
- CA- 15-3:
- It is raised in other malignancies like:
- Pancreatic cancer.
- Colorectal carcinoma.
- Liver.
- It is increased in stage I and II in 20% of the cases, while 70% to 80% in progressive diseases and metastatic breast cancer.
- It is increased in 75% of the cases with progressive disease.
- It decreases in 38% of the cases when it responds to therapy.
- The raised level was also seen in benign diseases like;
- liver diseases.
- Benign breast diseases.
- CA 15-3 and CA 27-29:
- It need not be done simultaneously. CA 15-3 is enough to perform. Both have the same purpose.
- What are other benign and malignant conditions?
- Lung cancer.
- Cirrhosis.
- Hepatitis.
- Fibrocystic diseases of the breast.
- Diseases of the prostate, pancreas, and colon.
Questions and answers:
Question 1: What is the significance of CA 15-3?
Question 2: Is there any benign condition where CA 15-3 is raised?
Breast cyst laboratory test with CA 15-3 and the result was 4.8 U/ml with normal 35.0, please advice if this laboratory test result is positive or negative cancerous? thank you.
This test is negative. CA 15-3 is used to monitor the therapy. If you have a lump in the breast, please do FNA or biopsy to confirm the diagnosis.
Lab test result showing CA 15-3 and result was 7.90. please is it within normal range? Help explain better please.
Lab test result showing CA 15-3 and result was 15.2, please what does it mean?
CA 15-3 result value 15.2 U/mL is negative. Normal value is <31 U/mL.
Please see this link, normal values are given.
https://labpedia.net/tumor-marker-part-9-ca-15-3-ca-27-29-cancer-antigen/
Hello Dr. Riaz,
Thank you for this thorough explanation. I’m a family nurse practitioner with about 6 years of experience. Unfortunately, I’ve been unwell for nearly 3 years. Various tests have revealed some abnormalities but I’ve yet to find the “smoking gun” so to speak. My quality of life has dramatically changed and I fear that, without a diagnosis and treatment soon, I don’t know if my body can handle much more. That being said, I’ve done a bit of amateur research myself and decided to run a few labs as a sort of “shot in the dark”. In doing so, I discovered my CA 15-3 level to be 32.7. Very high according to most journal citations. I immediately reached out to a breast doctor to ask for a mammogram but I was very surprised by his response to my request which was…. Angry and demeaning, to say the very least. I left feeling very vulnerable and hopeless. On doing a thorough breast exam on myself I discovered that my right breast is tender toward the armpit region, expresses a small amount of colostrum (my last baby is 4 years old and was not breastfed) and the areola seems to be shaped differently. In fact, the right breast seems almost swollen but not significantly. I don’t know what to do. I’m embarrassed and scared and feel very alone. Should I try to find another doctor to ask for a mammogram? I don’t really understand the reason why this last doctor said no other than being mean. Im only 37 but I do have a family history….
Am I really being that unreasonable?
Thank you for your thoughts!
V/R,
April
I think you can find an abnormality in the self-examination of the breast. You must consult a surgeon, and he can decide about a mammogram. Another simple test is ESR; if it is raised, you definitely have some disease in your body. Again ideally, consult a surgeon, and he can diagnose any lump or abnormality in the breast.
Lab test result of CA 15-3 was 30.1, please what does it mean?
It is the upper normal limit. Please repeat after one month. Do you have any symptoms? I hope the abdomen ultrasound was done.
Lab test result of CA 15-3 was 27,0 please what does it
Please, you have not given the History. The normal range is <31.0 U/mL.
CA 15 3 REACHING 40000U/L . CAN IT REACH THAT LEVEL
CA-53-3 in case malignancy can go high, depending on the tumor mass. Its value is a response to the treatment.
Hi my CA 15-3 cane back scoring 8
Your CA 15-3 is in the normal range. This shows the response of the treatment.
Your CA 15-3 is in the normal range. This shows the response to the treatment.
Your CA 15-3 is in the normal range (U/mL). This shows the response to the treatment.
In case of CA 15-3 goes down or return to normal, showing the effectiveness of the treatment.
CA 15-3 is 400 after a microdochectomy surgery….What does that mean please?…And what should be done next please?
This is the procedure to take the biopsy from the breast ducts. The tissue received needs to be sent for histopathology to diagnose the lesion. Fibroadenoma is to be removed by surgery, and again do histopathology of the removed fibroadenoma.
CA 15-3 is 400 a month after doing a Microdochectomy surgery….What does that mean please?…Also there is a fibroadenoma seen on right breast….What should be done next please?
CA-15-3 value of 400 units/ml is raised and suspicious for malignancy. That is why they did a biopsy, and now please wait for the report of the biopsy tissue.
My CA 15-3 after one month of the surgery was 3,8 and 6 months after came back 11,3 .Is it normal?
It is still in the normal range.
Dear Dr Riaz,
If my CA 15-3 score used to be around 20 post remission, (remission of 10 years post treatment) and is now 33.5, does this mena metasteses?
Please repeat CA 15-3 after one month, because it is borderline. Also have medical checkup to rule out any abnormality.
Thank you Dr