Can we trust tumour markers in pregnancy after breast cancer? A case of elevated CA 15-3 in the third trimester of pregnancy normalising after delivery

Buonomo, Barbara; Noli, S; Santini, Alessandra; Alviggi, Carlo; Peccatori, Fedro Alessandro

doi:10.3332/ecancer.2019.979

ecancer

2019

DOI: 10.3332/ecancer.2019.979

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Can we trust tumour markers in pregnancy after breast cancer? A case of elevated CA 15-3 in the third trimester of pregnancy normalising after delivery

Barbara Buonomo

S Noli

Alessandra Santini

et al.

Abstract: We realized a narrative review of the current literature starting from the case of a patient with raised CA15-3 during an uncomplicated pregnancy after breast cancer. The aim of our paper was to assess specificity, physiological changes and clinical utility of CA 15-3 monitoring during pregnancy after breast cancer, starting from clinical practice and retrieving the most relevant evidence in the literature.

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2023

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Cited by 2 publications

References 22 publications

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Elevation of cancer antigen 15-3 owing to oncocytic renal neoplasm in a patient without evidence of breast cancer recurrence on follow-up: a case report

Cockey,

Xu,

Al-Jumayli

2023

J Med Case Reports

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Background Cancer antigen 15-3 is a protein that clinicians commonly measure to monitor outcomes and response to treatment in patients with breast cancer. However, cancer antigen 15-3 can also be elevated in other, benign and malignant conditions. Case presentation A 73-year-old White woman with history of breast cancer presented to her primary care physician with right hip pain, and laboratory testing revealed elevated cancer antigen 15-3. Further workup with radiographic imaging revealed a large mass in her right kidney. The renal mass was subsequently removed, and the cancer antigen 15-3 level returned to normal. Conclusions Elevation of cancer antigen 15-3 owing to causes other than breast cancer recurrence can be a potential diagnostic pitfall during a patient’s follow-up. It is important for clinicians to be aware of the limitations of cancer markers and to utilize a combination of diagnostic tests for patient evaluation.

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Elevation of cancer antigen 15-3 owing to oncocytic renal neoplasm in a patient without evidence of breast cancer recurrence on follow-up: a case report

Cockey,

Xu,

Al-Jumayli

2023

J Med Case Reports

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Cancer and Pregnancy in the Post-Roe v. Wade Era: A Comprehensive Review

Arup,

Shravan

2023

Current Oncology

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Cancer during pregnancy, affecting 1 in 1000 pregnancies, is rising in incidence due to delayed childbearing and improved detection. Common types include breast cancer, melanoma and cervical cancer and Hodgkin’s Lymphoma. There are several physiological changes that occur during pregnancy that make its management a challenge to clinicians. Managing it requires multidisciplinary approaches and cautious test interpretation due to overlapping symptoms. To minimize fetal radiation exposure, non-ionizing imaging is preferred, and the interpretation of tumor markers is challenging due to inflammation and pregnancy effects. In terms of treatment, chemotherapy is avoided in the first trimester but may be considered later. Immunotherapy’s safety is under investigation, and surgery depends on gestational age and cancer type. Ethical and legal concerns are growing, especially with changes in U.S. abortion laws. Access to abortion for medical reasons is vital for pregnant cancer patients needing urgent treatment. Maternal outcomes may depend on the type of cancer as well as chemotherapy received but, in general, they are similar to the non-pregnant population. Fetal outcomes are usually the same as the general population with treatment exposure from the second trimester onwards. Fertility preservation may be an important component of the treatment discussion depending on the patient’s wishes, age and type of treatment. This article addresses the complicated nature of a diagnosis of cancer in pregnancy, touching upon the known medical literature as well as the ethical–legal implications of such a diagnosis, whose importance has increased in the light of recent judicial developments.

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Can we trust tumour markers in pregnancy after breast cancer? A case of elevated CA 15-3 in the third trimester of pregnancy normalising after delivery

Cited by 2 publications

References 22 publications

Elevation of cancer antigen 15-3 owing to oncocytic renal neoplasm in a patient without evidence of breast cancer recurrence on follow-up: a case report

Elevation of cancer antigen 15-3 owing to oncocytic renal neoplasm in a patient without evidence of breast cancer recurrence on follow-up: a case report

Cancer and Pregnancy in the Post-Roe v. Wade Era: A Comprehensive Review

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