Breast Carcinoma-Associated Antigen (CA 27.29), Serum
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Carcinoma of the breast is the most prevalent form of cancer in women. These tumors often produce mucinous antigens that are large-molecular-weight glycoproteins with O-linked oligosaccharide chains.
Monoclonal antibodies directed against these antigens have been developed, and several immunoassays are available to quantitate the levels of tumor-associated mucinous antigens in serum. The antibodies recognize epitopes of a breast cancer-associated antigen encoded by the human mucin 1 (MUC-1) gene, which is known by several names including MAM6, milk mucin antigen, CA 27.29, and cancer antigen 15-3 (CA 15-3).
While CA 27.29 is expressed at the apical surface of normal epithelial cells, it is present throughout malignant epithelial cells of the breast, lung, ovary, pancreas, and other sites. The cancer-associated form of the antigen is less extensively glycosylated than the normal form and more specific for tumor cells.
The FDA has approved CA 27.29 for serial testing in women with prior stage II or III breast cancer who are clinically free of disease.
Predicting early recurrence of disease in women with treated carcinoma of the breast
As an indication that additional tests or procedures should be performed to confirm recurrence of breast cancer
Increased levels of CA 27.29 (>38 U/mL) may indicate recurrent disease in a woman with treated breast carcinoma.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
This test provides results on female patients only at this time.
The use of CA 27.29 has not been demonstrated to provide clinical benefit to these patients, which has led some Mayo clinical investigators to conclude there is insufficient justification for routine clinical use of this new marker.
Measurement of CA 27.29 is not useful to screen women for carcinoma of the breast.
Some patients who have been exposed to mouse antigens, either in the environment or as part of treatment or imaging procedure, may have circulating antimouse antibodies present. These antibodies may interfere with the assay reagents to produce unreliable CA 27.29 results.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
> or =18 years: < or =38.0 U/mL (use not defined)
> or =18 years: < or =38.0 U/mL
Reference values have not been established for patients that are <18 years of age.
Serum markers are not specific for malignancy, and values may vary by method.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Bon GG, Von Mensdorff-Pouilly S, Kenemans P, et al: Clinical and technical evaluation of ACS BR serum assay of MUC1 gene-derived glycoprotein in breast cancer, and comparison with CA 15-3 assays. Clin Chem 1997;43:585-593
2. Chan DW, Beveridge RA, Muss H, et al: Use of Truquant BR radioimmunoassay for early detection of breast cancer recurrence in patients with stage II and stage III disease. J Clin Oncol 1997;15:2322-2328