Tumour Marker Tests for Breast Cancer
Breast cancer, a disease that affects the tissues of the breast, is the most commonly diagnosed cancer among women in Singapore, accounting for 29.7% of all cancers. It can develop in the ducts that carry milk to the nipple (ductal carcinoma) or in the glands that produce milk (lobular carcinoma). Early detection and screening are essential for improving treatment outcomes and survival rates.
While mammograms are often the go-to method for initial diagnosis, a different approach is needed to monitor treatment response and detect any potential recurrence—cancer tumour markers for breast cancer.
What are Cancer Tumour Markers?
Tumour markers are substances produced by cancer cells or by the body in response to cancer.
They can be detected in the blood, urine, or other bodily fluids. In breast cancer, tumour markers are primarily used to monitor the progression of the disease, assess the effectiveness of treatment, and detect recurrence after initial treatment.
When are Tumour Markers for Breast Cancer Used?
Since tumour marker levels in your body can provide insights into changes in the condition of the cancer, doctors use tumour marker tests in a number of different ways:
- Monitoring Treatment Responses During Treatment: Tumour marker levels are often measured before, during, and after treatment to assess how well the cancer is responding. A decrease in levels usually suggests the treatment is working, while an increase may indicate the need for a change in therapy.
- Post-Treatment Surveillance: After initial treatment is complete, tumour markers can be monitored to detect any signs of recurrence. Regular testing can help identify a relapse early on when treatment is often more effective.
- Prognosis and Treatment Planning: In some cases, tumour marker levels can help predict prognosis and guide treatment decisions. For example, higher levels of certain markers may indicate a more aggressive cancer or a higher risk of recurrence. This information can help doctors determine the most appropriate treatment approach. This is especially useful in advanced-stage breast cancer or for more aggressive subtypes, where treatment decisions are more complex.
- Inconclusive Mammogram Result: If a mammogram result is inconclusive, especially in women with dense breast tissue, tumour marker tests may be used alongside other imaging tests to provide further information and guide the next steps.
- Clinical Trials: Tumour markers may be used in clinical trials to assess the effectiveness of new treatments and to monitor participants' responses.
What Are the Limits to Using Tumour Markers to Test for Breast Cancer?
While tumour markers can be helpful tools, they're not a foolproof method for diagnosing or managing breast cancer. Normal levels of a breast tumour marker don't definitively rule out the presence of cancer, and elevated levels can sometimes occur in other conditions.
Here are some limitations to be aware of:
- Limited Sensitivity in Early Stages: Tumour markers may not be significantly elevated in the early stages of breast cancer, making early detection challenging.
- False Positives: Tumour marker levels can be elevated in non-cancerous conditions such as benign breast disease, liver disease, or even during menstruation. This can lead to false positives, where the test suggests cancer is present when it's not.
- Difficulty Monitoring Hormone-Sensitive Breast Cancers: In hormone-sensitive breast cancers, tumour marker levels may be affected by hormone therapy, making it challenging to accurately interpret the results.
- Tumour Heterogeneity: Breast cancers can be heterogeneous, meaning they contain different types of cancer cells with varying levels of tumour marker production. This can make it difficult to get a complete picture of the cancer's activity based on tumour marker levels alone.
- Affected by Medication and Menstrual Cycle: Certain medications and the menstrual cycle can also influence tumour marker levels, potentially leading to inaccurate results.
- Individual Variation: Tumour marker levels can vary significantly between individuals, making it difficult to establish a universal threshold for diagnosis or monitoring.
It's crucial to remember that tumour markers for breast cancer are just one part of the clinical picture. Doctors always use them in conjunction with other diagnostic tests, such as mammograms, ultrasounds, biopsies, and physical examinations, along with a comprehensive medical history.
What are the Tumour Marker Tests for Breast Cancer?
When it comes to monitoring breast cancer, there are four main tumour markers that doctors rely on. These are CA 15-3, CA 27.29, CA 125, and Carcinoembryonic Antigen (CEA).
- CA 15-3: This is the most commonly used tumour marker for breast cancer. It's often used to monitor treatment response and detect recurrence in individuals diagnosed with invasive breast cancer. However, it's not always elevated in the early stages of the disease.
- CA 27.29: Similar to CA 15-3, this marker is used to monitor treatment response and detect recurrence. Some studies suggest it may be more sensitive than CA 15-3 in detecting early recurrence.
- CA 125: While primarily associated with ovarian cancer, CA 125 can also be elevated in some cases of breast cancer, particularly those that have spread beyond the breast.
- Carcinoembryonic Antigen (CEA): Although not specific to breast cancer, CEA levels can be elevated in individuals with breast cancer that has spread to other organs, such as the liver or bones. It's important to note that CEA is not unique to breast cancer and can be used to monitor several other types of cancer as well. These include:
- Colorectal cancer
- Lung cancer
- Pancreatic cancer
- Stomach cancer
- Ovarian cancer
- Thyroid cancer
In addition to these, another important tumour marker for breast cancer is Human Epidermal Growth Factor Receptor 2 (HER2). HER2 is a protein found on the surface of some breast cancer cells.
HER2-positive breast cancers tend to grow and spread more quickly than HER2-negative cancers. Testing for HER2 is typically done on a biopsy sample of the tumour. The results of HER2 testing are important because they can guide treatment decisions. For example, if a tumour is HER2-positive, targeted therapies that specifically block HER2 activity may be recommended. Monitoring HER2 levels during treatment can also help assess how well the cancer is responding to therapy.
What's the Procedure for a Tumour Marker Test?
Getting a tumour marker test is a relatively straightforward process. It usually involves either a blood test, a urine test, or a biopsy. While the tumour marker test might cause some anxiety, it's generally a quick and minimally invasive procedure.
What to Expect During a Tumour Marker Test
- Blood test: The medical professional will use a needle to take a blood sample from a vein in your arm. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. The process may take around five minutes, and you may feel a slight discomfort during the procedure.
- Urine test: You will be provided a sterile container to prepare a urine sample for the medical professional to conduct analysis.
- Biopsy: A medical professional will remove a small piece of tissue from you, either by cutting or scraping the area.
How are the Results of a Tumour Marker Test Interpreted?
Interpreting tumour marker results requires careful consideration of various factors, including your medical history, current health status, and any ongoing treatments.
Doctors typically look for trends in tumour marker levels over time rather than focusing on a single result. A rise in levels may suggest disease progression or recurrence, while a fall may indicate a positive response to treatment.
It's important to consult with your healthcare professional for personalised guidance and interpretation of your tumour marker results. They can explain what the results mean in your specific context and discuss any necessary follow-up steps.
Financial Safety Net in the Event of a Breast Cancer Diagnosis
Tumour markers are valuable tools in monitoring breast cancer, helping doctors track treatment responses and detect potential recurrence. However, early detection and comprehensive treatment strategies are equally important for the best possible outcome. While these strategies are crucial, they can also put a significant strain on your finances.
This is why getting insured for critical illnesses is a wise decision, even while you're young and healthy. Remember that critical illness plans often do not cover illnesses and conditions diagnosed before you purchase the plan. Securing coverage early ensures you have a financial safety net in place should you face a breast cancer diagnosis in the future.
With Income’s Complete Cancer Care plan, you can alleviate the financial strain of treatment so that you and your loved ones can focus on cancer treatment and recovery.
Some key features of Complete Cancer Care include:
- Future premiums waived1 for a specified period up to the end of the policy term upon the diagnosis of major cancer.
- Receive up to 1% of the sum assured per month for up to 24 months2 to help reduce the out-of-pocket expenses for cancer treatment.
- First in Singapore to provide guaranteed post-cancer cover option3 - purchase a new term plan for extra coverage upon the diagnosis of advanced stage major cancer.
Learn more about Complete Cancer Care and prepare yourself for unexpected outcomes so you can manage the financial expenses following a cancer diagnosis with confidence.
1 Income will pay the Premium Waiver Benefit according to your selected option under the Major Cancer Benefit.
- If the policyholder selected Care 50, upon diagnosis of early or intermediate stage major cancer, Income will waive the premiums up to 60 months or end of policy term, whichever is earlier, and the policyholder will have to pay premiums thereafter. This benefit for early or intermediate stage major cancer can only be claimed once. Income will waive the premiums until the end of policy term upon diagnosis of advanced stage major cancer.
- If the policyholder selected Care 100, Income will waive the premiums until the end of policy term upon diagnosis of any stage of major cancer.
The premium waiver will start from the policy month immediately after the diagnosis date of the major cancer. The policy will continue to apply for the remaining unclaimed benefits during this premium waiver period even though the policyholder is not paying the premiums. Income will not pay this benefit if the insured suffered symptoms of, had investigations for, or was diagnosed with, any stage of major cancer any time before or within 90 days from the cover start date.
2 Income will pay a Monthly Cancer Therapy Benefit as long as the insured is diagnosed with major cancer by a specialist and recommended in writing that the treatment is a necessary medical treatment for cancer according to relevant guidelines from Ministry of Health (MOH) and has started cancer treatment as advised by a specialist. Income will make the first payment starting from the policy month immediately after the cancer treatment start date. For more details on the types of cancer treatment, please refer to the policy conditions. The maximum amount Income will pay for this benefit is $60,000 per life. Income will not pay more than a total number of 12 payouts for early or intermediate stage major cancer. If the insured has already received payouts during early stage, there will not be further payouts during intermediate stage. The sum of the total number of payouts for this benefit will not exceed 24 payouts. The number of payouts for the advanced stage major cancer will be 24 less the number of payouts Income have paid for the early or intermediate stage major cancer under this benefit. Income will not pay this benefit if the insured suffered symptoms of, had investigations for, or was diagnosed with, any stage of major cancer any time before or within 90 days from the cover start date. Please refer to the policy conditions for further details.
3 Upon diagnosis with advanced stage major cancer, the insured may choose to take up a new term policy with only death, terminal illness and total and permanent disability (TPD) benefits on the insured own life, without Income having to assess their health. The waiting period of the new term policy is 2 years. If the insured makes a claim on the new term policy during the 2 years of waiting period, Income will refund 100% of the premiums paid on the term policy issued under this option.
The sum assured for the new term policy will be limited to:
- 100% of the sum assured for this policy; or
- $200,000 per life
aggregating policies issued under the guaranteed post-cancer cover option, whichever is lower.
Income will decide the type of new policy to be offered and the insured must meet all the following conditions to take up this option:
- The insured must take up this option within 6 months from the date of claim admittance of the advanced stage major cancer benefit.
- The insured must not be totally and permanently disabled, terminally ill or be diagnosed with an advanced-stage dread disease other than major cancer, at the time of taking up this option.
- The insured must be 60 years old last birthday or under at the time of taking up this option.
This article is meant purely for informational purposes and does not constitute an offer, recommendation, solicitation or advise to buy or sell any product(s). It should not be relied upon as financial advice. The precise terms, conditions and exclusions of any Income Insurance products mentioned are specified in their respective policy contracts. Please seek independent financial advice before making any decision.
These policies are protected under the Policy Owners’ Protection Scheme which is administered by the Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from you. For more information on the types of benefits that are covered under the scheme as well as the limits of coverage, where applicable, please contact Income Insurance or visit the GIA/LIA or SDIC websites (www.gia.org.sg or www.lia.org.sg or www.sdic.org.sg).
This advertisement has not been reviewed by the Monetary Authority of Singapore.
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