CA-125 is an important part of the workup for suspicious adnexal masses and for for following treated ovarian cancer. It is not a common marker in clinical use for breast cancer or for screening for ovarian cancer. In one recent study, thirty-three patients had increasing or continuously high concentrations of CA 125. Thirty (91%) of these had involvement of the pleura, either as pleural metastasis or metastasis in surrounding tissue i.e. bone structures in the thorax cavity or lung parenchyma. MUC1 and CEA were elevated in 27 (82%) and 24 (73%) of the 33 patients, respectively. Increased concentrations of these two markers did not relate to the site of metastasis. However, the three tumor markers complemented each other in detecting early metastases. Increased CA 125 was associated with metastasis in or near the pleura, and in stage IV breast cancer it was related to poor prognosis. Another study suggested that it can be elevated with any cancer that involves pleural surface, just like ovarian cancer involves peritoneal surface. As such, Ca-125 can be potentially misleading if used as marker for breast cancer or to screen for ovarian cancer in the absence of findings.
Samuel S et al, .Validation of Referral Guidelines for Women With Pelvic Masses
Obstetrics & Gynecology 2005;105:35-41
Amy C. Dearking et al, How Relevant Are ACOG and SGO Guidelines for Referral of Adnexal Mass?Obstetrics & Gynecology 2007;110:841-848
Lars F. Noruma et al, Elevated CA 125 in Breast Cancer – A Sign of Advanced Disease Tumor Biology Vol. 22, No. 4, 2001
D. Shitrit, B. Zingerman, A. B.-G. Shitrit, D. Shlomi, and M. R. Kramer
Diagnostic Value of CYFRA 21-1, CEA, CA 19-9, CA 15-3, and CA 125 Assays in Pleural Effusions: Analysis of 116 Cases and Review of the Literature Oncologist, August 1, 2005; 10(7): 501 – 507.
J.E. Dodge wt al, Practice Guideline Series, Management of a suspicious adnexal mass: a clinical practice guideline, OncologyVol 19, No 4 (2012)
Michael P. Stany1, G. Larry Maxwell and G. Scott Rose Women’s Imaging Review: Clinical Decision Making Using Ovarian Cancer Risk AssessmentAJR February 2010, Volume 194, Number 2,