Understanding Elevated CEA Levels After Cancer Treatment: What Does It Mean?

Question
My mom had breast cancer 10 years ago, treated with chemo, sugery and radiation. She recently had an abnormal mammogram, followed by an MRI and Ultra-sound, but nothing has been conclusive. Her CEA count has gone from 16 to 800 in the past 9 months. What does this count mean, and how can they tell the new cells are coming from the breast area?  She wants to have a prophylactic mastectomy on the other side, but of course, she feels that may be a little radical. Thank you for your time and effort. PS she is 73 and healthy otherwise. Karey L. McCormick

Answer
Dear Karen,   CEA is a tumor marker blood test and CEA is a protein in the body....  CEA is usually use as POST-breast cancer tools because it is believed that when the CEA starts going UP, the cancer has returned....  However, this is not a specific test for breast cancer....  It was first used to detect and follow colon cancer patients after their surgery and cancer treatment, so this is why it is so non-specific...

The fact that the mammogram was abnormal and the MRI and Ultra-sound are not conclusive, it sounds like she needs to go somewhere else for a ssecond MRI, mammogram and Ultra-sound as often one radiologist will NOT catch a tumor when another one will....

As far as telling if this increase in CEA is from the breast, it is hard to say....  The doctors need to do a COMPLETE body MRI or CT-scan including the brain and the bones, since breast cancer even after 10 years can spread to other organs like the lungs, brain and bones and even the colon....

I would "strongly" suggest that you have your mother sign a release of records at the hospitals or clinics where these mammograms, MRI's and Ultra-sounds were done and get them, read them and see for YOURSELF what the radiologist is truthfully telling the doctors....  If you need help with what the radiologist impression is, get back to me with what these say.....

thank you,   karen