Expert: Claes-Gustaf Nordquist, M.D. - 12/6/2011

Question
I was dx on year ago,stage 2a, bilat. mastectomy, node negative breast cancer. Had chemo and herceptin. Finished herceptin last week, chemo in April.Preoperative CEA only(.7) with tumor inside, ca 15.3 was 5.4. values remained at 1.3/1.1/1.0 cea even after chemo,. 6 weeks after chemo(march) it began to rise; 2.7, 3.7, 3.6, 5.4, 3.9, 4.7,6.0 and 5.4 in that order every 3 weeks.UNL in my lab is 5.0.ca15.3 has remained very low at around 8 (UNL. 31) Had 2 PET (one before surgery and another 5 months ago)
after second cea rise. all ok. second PET showed inflammation along mastectomy scars and thyroiditis, later found to be hypothyroid and on medication. My onc and other docs I have asked are not concerned. My onc is sure is Tamoxifen (surge began after I began taking it)and proposed changing to AI.Im schedule for another PET because of my final reconstruction and port removal. I'm scare about CEA meaning mets. Is this significant to worry about,I read hypothyroidism can elevate CEA but not about tamoxifen but the timing is suspicious. please advise

Answer
For the time being at least I have to agree with your doctors. If active tumor tissue was involved producing this CEA it SHOULD be detected by your PET scans. However guarantees are difficult or impossible to give in oncology. But so far there is no evidence of any mets. Please do keep me posted!


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