Tumor markers in breast cancer - European Group on Tumor Markers recommendations

Recommendations are presented for the routine clinical use of serum and tissue-based markers in the diagnosis and management of patients with breast cancer. Their low sensitivity and specificity preclude the use of serum markers such as the MUC-1 mucin glycoproteins ( CA 15.3, BR 27.29) and carcinoembryonic antigen in the diagnosis of early breast cancer. However, serial measurement of these markers can result in the early detection of recurrent disease as well as indicate the efficacy of therapy. Of the tissue-based markers, measurement of estrogen and progesterone receptors is mandatory in the selection of patients for treatment with hormone therapy, while HER-2 is essential in selecting patients with advanced breast cancer for treatment with Herceptin ( trastuzumab). Urokinase plasminogen activator and plasminogen activator inhibitor 1 are recently validated prognostic markers for lymph node-negative breast cancer patients and thus may be of value in selecting node-negative patients that do not require adjuvant chemotherapy. Copyright (C) 2005 S. Karger AG, Basel

RELATIONSHIP BETWEEN LYMPHOSCINTIGRAPHY AND CLINICAL FINDINGS IN LOWER LIMB LYMPHEDEMA (LO): TOWARD A COMPREHENSIVE STAGING

Although radionuclide lymphoscintigraphy(RNL) is widely used diagnosticallyfor patients with lymphedema (LE), it has notbeen utilized for LE staging, which is stillbased upon clinical findings. The aim of thiswork is to establish whether the results ofboth conventional RNL and fusion imagingobtained from hybrid detectors may be usedfor a comprehensive clinicoimaging staging inLE. Radiolabeled nanocolloids (0.2 ml) weresubcutaneously injected in 4,328 patients(23-78 years) with clinical lower limb LE andwithout venous disease. Patients wereclassified according to the ISL classificationand had a minimal follow-up of 2 years.Images were taken 60 minutes after theinjection as a whole body scanning and fusionimages of functional SPET and anatomicalCT. Clinical and RNL results were not inaccordance, and a specific RNL staging wasestablished. The association of clinical andfunctional staging yields a new method tograde LE patients, and this staging correlatedwith treatment efficacy. RNL is an importanttool in lymphology, and its association withthe clinical evaluation offers a new gradingsystem which may be able to delineate patientswith good prognosis, patients at risk for acomplex decongestive physiotherapy (CDP)failure, and patients who may benefit fromother therapeutic protocols