How do you monitor patients with metastatic breast cancer?

NCCN Guidelines recommend regular office visits, lab testing, and imaging studies, but there is a wide range of recommendations for the frequency, i.e. 6 weeks to 6 months and these are not based on prospective data. NCCN and ASCO guidelines recommend that metastatic disease be monitored in selected patients using serum tumor markers (STMs) such as CEA, CA 15-3, and CA 27.29. In this setting, STM sensitivity is 50-96% and levels correlate with disease progression, regression, and stability. There is considerable uncertainty in the community regarding the optimal timing and modality for disease monitoring.

We are now enrolling patients on to S1703, a prospective randomized trial that looks at serum tumor directed disease monitoring (i.e. fol...