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Should I Still Continue My Oncology Tests Inspite Of Having All The Recent Reports?

Posted on Thu, 13 Mar 2014

Question: I was diagnosed with Stage I Triple negative, BRCA 2 + breast cancer at 51 yrs of age. Hx. premenopausal breast ca maternal aunt. I completed chemo and had bilateral mastectomies and bilateral salpingoophorectomy - all completed between 11/2011 and 6/2012. Since then q3mth oncology visits with labs: cbc, cmp, ca-15. My CA-15 has slowly increased from 12.8 in 8/2012 to 20.4 today. I know this is still WNL but the trend still concerns me but apparently not my oncologist. She said that if I am concerned about this trend then she can stop doing the test.......... i just can't let it go.......what do you think/

Answered by Dr. Cori Baill (36 minutes later)

Brief Answer: Thank you for writing. I agree with your concern. Detailed Answer: CA15 like other tumor markers has limitations. It is not very precise. You had an early breast cancer that was aggressively treated. But BRCA + patients deserve close scrutiny. Has your oncologist considered a PET scan? If negative , I think it would be very reassuring.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Cori Baill (32 minutes later)

Thanks for your thoughts. My oncologist has not suggested any followup scans. Last Bone scan done in 8/2012, last PET in 4/2012. at my last appointment she said that if the cancer recurs, it is always a stage iv and the outcome is no different whether we find it today or next year...... we will only be treating symptoms not curing. This makes me feel like i am being paranoid and not wanting to ask for a PET scan...... your thoughts?

Answered by Dr. Cori Baill (7 hours later)

Brief Answer: I would not discount your inner voice. Detailed Answer: Of course it is possible to be over anxious and worried, but your concern seems reasonable to me. I am not sure I share your oncologists point of view about now vs a year from now. It has been over a year, almost 2 since a negative PET, and considering that a negative test outcome has the great value of reassurance, permitting you to relax and enjoy your remission, I think it is a reasonable test to request. I also think early detection of recurrence is often associated with a better outcome. Perhaps it is time to consult with a nearby oncologist for a second opinion? One that is associated with a medical school, and specializes in breast cancer? Do not hesitate to be your own advocate.

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Above answer was peer-reviewed by : Dr. Prasad