Originally published as JCO Early Release 10.1200/JCO.2007.14.2364 on October 22 2007

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American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast Cancer

Lyndsay Harris, Herbert Fritsche, Robert Mennel, Larry Norton, Peter Ravdin, Sheila Taube, Mark R. Somerfield, Daniel F. Hayes, Robert C. Bast, Jr

From the Yale Cancer Center, Yale University, New Haven, CT; M.D. Anderson Cancer Center, Houston; Texas Oncology PA, Dallas, TX; Memorial Sloan-Kettering Cancer Center, New York, NY; National Cancer Institute, Bethesda, MD; American Society of Clinical Oncology, Alexandria, VA; University of Michigan Medical Center, Ann Arbor, MI

Address reprint requests to American Society of Clinical Oncology, 1900 Duke St, Suite 200, Alexandria, VA 22314; e-mail: guidelines{at}asco.org

Purpose: To update the recommendations for the use of tumor marker tests in the prevention, screening, treatment, and surveillance of breast cancer.

Methods: For the 2007 update, an Update Committee composed of members from the full Panel was formed to complete the review and analysis of data published since 1999. Computerized literature searches of MEDLINE and the Cochrane Collaboration Library were performed. The Update Committee's literature review focused attention on available systematic reviews and meta-analyses of published tumor marker studies. In general, significant health outcomes (overall survival, disease-free survival, quality of life, lesser toxicity, and cost-effectiveness) were used for making recommendations.

Recommendations and Conclusions: Thirteen categories of breast tumor markers were considered, six of which were new for the guideline. The following categories showed evidence of clinical utility and were recommended for use in practice: CA 15-3, CA 27.29, carcinoembryonic antigen, estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, urokinase plasminogen activator, plasminogen activator inhibitor 1, and certain multiparameter gene expression assays. Not all applications for these markers were supported, however. The following categories demonstrated insufficient evidence to support routine use in clinical practice: DNA/ploidy by flow cytometry, p53, cathepsin D, cyclin E, proteomics, certain multiparameter assays, detection of bone marrow micrometastases, and circulating tumor cells.

published online ahead of print at www.jco.org on October 22, 2007.

Approved by the Board of Directors Executive Committee on July 12, 2007.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

Related Correspondence

• Reaction to American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast Cancer
  Rene Bernards
  JCO 2008 26: 2057-2058 [Full Text]
• Inconsistent Criteria Used in American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast Cancer
  Fatima Cardoso, Mahasti Saghatchian, Alastair Thompson, Emiel Rutgers, and for the TRANSBIG Consortium Steering Committee
  JCO 2008 26: 2058-2059 [Full Text]

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