American Society of Clinical Oncology 2007 update of recommendations for the use of tumor markers in breast cancer

J Clin Oncol. 2007 Nov 20;25(33):5287-312. doi: 10.1200/JCO.2007.14.2364. Epub 2007 Oct 22.


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.

Publication types

  • Review

MeSH terms

  • Antigens, Tumor-Associated, Carbohydrate / blood
  • Biomarkers, Tumor / analysis*
  • Bone Marrow / pathology
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / drug therapy
  • Carcinoembryonic Antigen / analysis
  • Cathepsin D / analysis
  • Cell Proliferation
  • Cyclin E / analysis
  • Drug Resistance, Neoplasm
  • Female
  • Gene Expression Profiling
  • Humans
  • Mucin-1 / blood
  • Neoplastic Cells, Circulating
  • Plasminogen Activator Inhibitor 1 / analysis
  • Practice Guidelines as Topic
  • Proteomics
  • Receptor, ErbB-2 / analysis
  • Receptors, Estrogen / analysis
  • Receptors, Progesterone / analysis
  • Tumor Suppressor Protein p53 / analysis
  • Urokinase-Type Plasminogen Activator / analysis


  • Antigens, Tumor-Associated, Carbohydrate
  • Biomarkers, Tumor
  • CA 27-29 antigen
  • Carcinoembryonic Antigen
  • Cyclin E
  • Mucin-1
  • Plasminogen Activator Inhibitor 1
  • Receptors, Estrogen
  • Receptors, Progesterone
  • Tumor Suppressor Protein p53
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Urokinase-Type Plasminogen Activator
  • Cathepsin D