what would these markers denote? Markers for breast cancer itself: mammaglobin? For prognosis: uPA and PAI1? For treatment sensitivity: HER2 (for herceptin)? etc.

Ca125 is not used.

For prognosis, ER, PR and HER2 are the basis. You can add Ki67.

They are tissue markers that you can measure with IHC.

As Paul Span has well said, first what is your aim ? (is it a breast cancer, for prognosis and relapse, to classify patients, or to apply the best treatment) Then some answers will be given.

We usually follow up CA 15-3 to evaluate the treatment effect as well as recurrence and prognosis

As breast cancer has been sudivided in multiple molecular subtypes, the answer depends on what subtype you are dealing with.

How about CA 27 29 used for non metastatic cancer to evaluate treatment. See the base value and follow the trend.

Following are few new biomarkers and there studies:

GGI, : Sotiriou C, Wirapati P, Loi S, et al: Gene expression profiling in breast cancer: Understanding the molecular basis of histologic grade to improve prognosis. J Natl Cancer Inst 98:262-272, 2006

Gene70 : van’t Veer LJ, Dai H, van de Vijver, et al: Gene expression profiling predicts clinical outcome of breast cancer. Nature 415:530-536, 2002

CIN70 :Carter SL, Eklund AC, Kohane IS, et al: A signature of chromosomal instability inferred from gene expression profiles predicts clinical outcome in multiple human cancers. Nat Genet 38:1043-1048, 2006

stroma : a-related gene signature predicts resistance to neoadjuvant chemotherapy in breast cancer. Nat Med 15:68-74, 2009

stroma : Desmedt C, Haibe-Kains B, Wirapati P, et al: Biological processes associated with breast cancer clinical outcome depend on the molecular subtypes. Clin Cancer Res 14:5158-5165, 2008

immune : Teschendorff AE, Miremadi A, Pinder SE, et al: An immune response gene expression module identifies a good prognosis subtype in estrogen receptor negative breast cancer. Genome Biol 8:R157, 2007

immune : Desmedt C, Haibe-Kains B, Wirapati P, et al: Biological processes associated with breast cancer clinical outcome depend on the molecular subtypes. Clin Cancer Res 14:5158-5165, 2008

RAS : Bild AH, Yao G, Chang JT, et al: Oncogenic pathway signatures in human cancers as a guide to targeted therapies. Nature 439:353-357, 2006

MAPK Creighton : CJ, Hilger AM, Murthy S, et al: Activation of mitogen-activated protein kinase in estrogen receptor alpha-positive breast cancer cells in vitro induces an in vivo molecular phenotype of estrogen receptor alpha-negative human breast tu- mors. Cancer Res 66:3903-3911, 2006

PTEN loss, : Saal LH, Johansson P, Holm K, et al: Poor prognosis in carcinoma is associated with a gene expression signature of aberrant PTEN tumor sup- pressor pathway activity. Proc Natl Acad Sci U S A 104:7564-7569, 2007

AKT/ mTOR : Majumder PK, Febbo PG, Bikoff R, et al: MTOR inhibition reverses Akt-dependent prostate intraepithelial neoplasia through regulation of apo- ptotic and HIF-1-dependent pathways. Nat Med 10:594-601, 2004

PI3KCA : Loi S, Haibe-Kains B, Majjaj S, et al: PIK3CA mutations associated with gene signature of low mTORC1 signaling and better outcomes in estrogen receptor-positive breast cancer. Proc Natl Acad Sci U S A 107:10208-10213, 2010

IGF1: Creighton CJ, Casa A, Lazard Z, et al: Insulin- like growth factor-I activates gene transcription pro- grams strongly associated with poor breast c

and many more

Well thank you all for your comments and i am happy to get so much data at just one point, what my focus is to basically Classify the cancer with the help of my marker. thanx Sandeep Singhal for the articles name,...

We use ER,PR, CerbB-2, P53

Hi . . I've worked with breast cancer sensor. After a lot of literatury survey, we got proof for ca 15.3. It's more specific and also sensitive. All the best for your work

I am just wondering, did anyone tested CA 15-3 in women with Dense Breasts condition and Fibrocystic Disease of the breasts (on imaging) vs. normal breast tissue? Now, in the state of Texas it is required by law that women are informed at the time of screening mammo if they do have dense breast tissue as it can alter the outcome.

Thank you to Sandeep Singhal!

Yeah, ASCO latest recommendations are 2007.

CA 15-3

Lucie Sefrhansova: :)

Good point: what kind of markers? Tumor markers? Or histological markers? Regarding classical tumor markers, ASCO guidelines can give you a good orienteering. Histological markers? Classicals are: HER2, ER, PR, Grade; relatively new ones: topo2alpha, Ki67. And different type of gene signatures...

what about cytokeratins to identifiy basal like phenotype? CK14 CK5/6 and others have been used to identify this subtype, it is associated with poor prognosis.

Thank you so much Laszlo Torday, Ramon Garcia and Sarah Dean. I have to think over topo 2alpha, Ki67. p53 has shown good results but i would also be interested in p 63 & 73. No one has ever spoken on Cytokeratin especially Ck AE1/AE3.

Thank you so much John Mark Pabona. I would defiantly look into them

CA 15-3 is also a good breast cancer marker, not for screening, but mostly for follow-up purpose, especially in cases where the pre-treatment level is known.