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Does Tamoxifen Raise CEA Levels ?

Posted on Fri, 13 Apr 2012

Question: I finished chemo(TCH) for breast cancer node negative,2.4cm, no lymphovascular invasion 12 weeks ago.Had Pet scan prior to surgery and was ok.My CEA was only(.7) with the tumor inside (had bilat mastectomy).
During chemo was 1.3, 1.1 and 1.0 then 6 weeks after chemo 2.7, 3.7, 3.6 and today 5.4. Upper normal limit is (5) in my lab. ca 15.3 has been from 5.3 to 9.5 and UNL is 32. I had second PET 4 weeks ago and was ok, no uptake. showed some inflammation around the mastectomy scars. I started Tamoxifen just after the 2.7 reading. My oncologists said that Tamoxifen can raise CEA along with the residual inflammation seen in PET. She is not worried but I am.Do you think this is significant despite recent negative PET? how come CEA was so low with the tumor still inside, wouldn't it have been elevated back then? Do you agree with tamoxifen being able to cause this elevation now a bit over limit/
thanks

Follow up: Dr. Indranil Ghosh (1 hour later)

correction:surgery was 9 months ago, second PET, 4 weeks ago

Answered by Dr. Indranil Ghosh (14 hours later)

Hi,

Thanks for posting your query.

It is good to know you are doing well. You have early node-negative breast cancer and received herceptin also.

The results of the test are not significant. I agree with your oncologist comments. They are not concerning to me. These tests are not recommended for follow up of breast cancer, more so for early stage (Ref NCCN, ASCO & ESMO guidelines for management of breast cancer).

I advise you to get back to your normal lifestyle as early as possible. Maintain healthy diet, do regular exercise and keep body weight as normal as possible.

Hope I have answered your query. Should you have any more concerns, I will be available to answer them.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Indranil Ghosh (3 hours later)

how about CEA being so low preop with the tumor still inside, also, I remember having lot of leg musle pain probable myosists/myalgia 3 weeks after chemo and lasted 1 month. can this kind of inflammation also can raise CEA? my biggest concern was that during chemo CEA was low. I appreciate

Answered by Dr. Indranil Ghosh (11 hours later)

Hello,

Thanks for writing again.

Sometimes inflammatory or infective disorders can raise the CEA.

It is a non-specific test and does not help in this scenario. Go through this excerpt from the American Society of Clinical oncology (ASCO) guidelines..."Carcinoembryonic antigen (CEA) is not recommended for screening, diagnosis, staging, or routine surveillance of breast cancer patients after primary therapy" (Ref Lyndsay XXXXXXX et al. Journal of Clinical Oncology Nov 2007).

Hope my answer is helpful.

Regards.

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Above answer was peer-reviewed by : Dr. Manju M