Postoperative follow-up of breast cancer patients: overview and progress in the use of tumor markers.

The role of serial measurement of serum tumor-associated antigens (TAA) in the postoperative follow-up of breast cancer patients is not considered by most authors. The authors of this article review the literature and original data showing benefits from the use of TAA in the postoperative follow-up of breast cancer patients. An increase in the lead time from the first pathological finding to the definite evidence of distant metastases has been observed in follow-up studies which have used TAA compared to those which did not use them. The sensitivity and specificity of TAA in the diagnosis of distant metastases have been markedly improved by selecting an appropriate combination of TAA and by identifying specific conditions associated with breast cancer responsible for false-positive results as well as by adopting a 'dynamic' evaluation of multiple successive determinations of TAA. TAA accurately predict patients with bone metastases and can be used to guide imaging techniques. The anticipation of distant metastasis by TAA can be used to initiate a relatively early treatment which has been shown to prolong overall survival in a previous study. It is hoped that these data will stimulate further trials including TAA in the follow-up of breast cancer patients. Copyright 2000 S. Karger AG, Basel