Nuclear Medicine Section, Radiology Department, Aga Khan University Hospital, Nairobi, Kenya; and
Nuclear Medicine Section, Radiology Department, Aga Khan University Hospital, Nairobi, Kenya; and.
J Nucl Med. 2024 Oct 1;65(10):1521-1525. doi: 10.2967/jnumed.124.267851.
The tumor marker cancer antigen 15-3 (CA 15-3) is that most commonly used to monitor metastatic breast cancer during active therapy and surveillance for disease recurrence after treatment. The association of CA 15-3 and F-FDG PET/CT findings can be considered complementary, since any significant rise may indicate the presence of disease and imaging is able to map the tumor sites. Although current guidelines do not recommend the routine performance of CA 15-3 in asymptomatic patients being followed up after definitive breast cancer treatment, most oncologists perform serial assessment of the tumor markers as part of routine follow-up of patients. The aim of this study was to evaluate the correlation between CA 15-3 levels and F-FDG PET/CT scan findings in patients with recurrent breast cancer. This was a cross-sectional study with data collected retrospectively. Patients being evaluated for breast cancer recurrence with F-FDG PET/CT imaging and CA 15-3 level were included. Evaluation of the association between CA 15-3 levels and F-FDG PET/CT scan findings was then done. In total, 154 cases were included in this study; 62 patients had recurrence (positive) on the F-FDG PET/CT scans, whereas 92 patients had normal (negative) findings on follow-up F-FDG PET/CT scans. There was an association between CA 15-3 levels and the presence or absence of recurrence on F-FDG PET/CT scans, with 84.4% (27/32) of patients who had elevated CA 15-3 levels having disease recurrence on F-FDG PET/CT and 84.4% (27/32) of patients who had elevated CA 15-3 levels having disease recurrence on F-FDG PET/CT as well as a correlation with the burden of metastases. Most patients with disease recurrence on F-FDG PET/CT, however, had normal CA 15-3 levels. Higher CA 15-3 levels correlate with breast cancer recurrence on F-FDG PET/CT as well as with burden of metastasis. Notably, CA 15-3 levels within the reference range do not exclude breast cancer disease recurrence since more than half of patients with recurrence had normal CA 15-3 levels. F-FDG PET/CT should therefore be considered in patients with suspected breast cancer recurrence but normal CA 15-3 levels.
肿瘤标志物癌抗原 15-3（CA 15-3）是在积极治疗期间监测转移性乳腺癌以及治疗后疾病复发时最常使用的标志物。CA 15-3 与 F-FDG PET/CT 结果的相关性可以被认为是互补的，因为任何显著升高都可能表明存在疾病，而影像学能够对肿瘤部位进行定位。尽管目前的指南不建议在接受确定性乳腺癌治疗后进行无症状患者的常规 CA 15-3 检测，但大多数肿瘤学家仍将作为患者常规随访的一部分进行肿瘤标志物的连续评估。本研究旨在评估复发乳腺癌患者中 CA 15-3 水平与 F-FDG PET/CT 扫描结果之间的相关性。这是一项回顾性收集数据的横断面研究。纳入接受 F-FDG PET/CT 成像和 CA 15-3 水平评估以检测乳腺癌复发的患者。然后对 CA 15-3 水平与 F-FDG PET/CT 扫描结果之间的相关性进行评估。共有 154 例患者纳入本研究；62 例患者的 F-FDG PET/CT 扫描结果显示有复发（阳性），92 例患者的 F-FDG PET/CT 扫描结果为正常（阴性）。CA 15-3 水平与 F-FDG PET/CT 扫描结果的存在或不存在之间存在相关性，其中 84.4%（27/32）CA 15-3 水平升高的患者在 F-FDG PET/CT 上有疾病复发，84.4%（27/32）CA 15-3 水平升高的患者在 F-FDG PET/CT 上有疾病复发，并且与转移灶的负荷相关。然而，大多数在 F-FDG PET/CT 上有疾病复发的患者 CA 15-3 水平正常。CA 15-3 水平越高，与 F-FDG PET/CT 上的乳腺癌复发以及转移灶的负荷相关性越高。值得注意的是，CA 15-3 水平在参考范围内并不能排除乳腺癌疾病的复发，因为超过一半的复发患者 CA 15-3 水平正常。因此，对于怀疑有乳腺癌复发但 CA 15-3 水平正常的患者，应考虑 F-FDG PET/CT。
