CA 15-3

At a Glance

Why Get Tested?

To monitor the response to treatment of invasive breast cancer and to help watch for recurrence of the disease

When To Get Tested?

When you have been or are being treated for invasive breast cancer

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?

None

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Looking For Reference Ranges?

You may be able to find your test results on your laboratory’s website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab’s website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab’s website or portal, or contact your healthcare practitioner in order to obtain your test results.

Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called “normal” values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are “within normal limits.”

For more information, please read the article Reference Ranges and What They Mean.

What is being tested?

Cancer antigen 15-3 (CA 15-3) is a protein that is produced by normal breast cells. In many people with cancerous breast tumors, there is an increased production of CA 15-3 and the related cancer antigen 27.29. CA 15-3 does not cause cancer; rather, it is shed by the tumor cells and enters the blood. This test measures CA 15-3 in the blood.

Since CA 15-3 can be measured in the blood, it is useful as a tumor marker to follow the course of the cancer. CA 15-3 is elevated in fewer than 50% of women with early localized, breast cancer or with a small tumor, but is elevated in about 80% of those with breast cancer that has spread (metastatic). Because not all women with invasive breast cancer will have elevated CA 15-3, the test is not useful in all cases.

CA 15-3 is not recommended as a screening test to detect breast cancer in women because it is non-specific. It may also be elevated in healthy people and in individuals with other cancers such as colon, lung, pancreas, ovarian, or prostate malignancies or certain conditions such as cirrhosis, hepatitis, and benign breast disease.

Common Questions

How is it used?

The cancer antigen 15-3 (CA 15-3) test and the related CA 27.29 test are mainly used to monitor response to breast cancer treatment and to help watch for breast cancer recurrence. They are used along with other clinical evaluations and tests, such as estrogen and progesterone receptors, Her2/neu, and gene expression tests for breast cancer, to evaluate a person’s breast cancer.

CA 15-3 is sometimes ordered to provide a general sense of how much cancer may be present (the tumor burden). CA 15-3 can only be used as a marker if the cancer is producing elevated amounts of it, so this test is not useful for all people with breast cancer.

The CA 15-3 and CA 27.29 tests are not sensitive or specific enough to use as a screening test for cancer because non-cancerous conditions can cause elevated levels.

When is it ordered?

CA 15-3 may be ordered along with other tests when advanced breast cancer is first diagnosed to help determine cancer characteristics and treatment options. If CA 15-3 is initially elevated, then it may be ordered periodically to monitor the effectiveness of treatment and to help watch for recurrence. CA 15-3 is usually not ordered when breast cancer is detected early, before it has spread (metastasized), because levels will not be elevated in the majority of early cancers.

What does the test result mean?

In general, the higher the CA 15-3 level, the more advanced the breast cancer and the greater the amount of cancer present (tumor burden). CA 15-3 concentrations tend to increase as the cancer grows. In metastatic breast cancer, the highest levels of CA 15-3 often are seen when the cancer has spread to the bones and/or the liver.

Increasing concentrations of CA 15-3 over time may indicate that a person is not responding to treatment or that the cancer is recurring.

Normal CA 15-3 levels do not ensure that a person does not have localized or metastatic breast cancer. It may be too early in the disease process for elevated levels of CA 15-3 to be detected or the person may be one of the roughly 20% to 25% of individuals with advanced breast cancer whose tumors do not shed CA 15-3.

Mild to moderate elevations of CA 15-3 are seen in a variety of conditions, including cancer of the lung, pancreas, ovary, prostate, and colon as well as cirrhosis, hepatitis, and benign breast disorders and in a certain percentage of apparently healthy individuals. The CA 15-3 elevations seen in non-cancerous conditions tend to be stable over time.

Is there anything else I should know?

Laboratories may use different methods to test for CA 15-3, so results can vary from lab to lab. If you are having a series of CA 15-3 tests done, it is advised that you have the tests done by the same method, typically by the same laboratory, so that the results can be compared and interpreted correctly. You may wish to discuss this issue with your healthcare practitioner.

Levels of CA 15-3 are not usually measured immediately after breast cancer treatment begins. There have been instances of transient increases and decreases in CA 15-3 that do not correlate with the person’s progress. Usually, the healthcare practitioner will wait a few weeks after starting treatment to begin monitoring CA 15-3 levels.

Should I have a test for CA 27.29 in addition to the CA 15-3 test?

No. Although it has a different name, the CA 27.29 test measures the same protein as CA 15-3 and is used in the same way. It can be used instead of CA 15-3, but you don’t need both tests.

I have a strong family history of breast cancer. Shouldn't I be screened for CA 15-3?

CA 15-3 is not recommended as a screening tool. It is not specific or sensitive enough to detect early breast cancer. Elevations in CA 15-3 may be due to other causes, and a normal value does not ensure that you do not have cancer. As a rule, it should only be used after breast cancer has been diagnosed.

How long will it take for results?

This depends on the laboratory performing the testing. Not every lab performs this test and your sample may need to be sent to a reference laboratory for testing. It may take several days to a week for results to be available.

View Sources

Sources Used in Current Review

Penn Medicine Oncolink® (28 April 2016 updated). Patient Guide to Tumor Markers. Available online at http://www.oncolink.org/treatment/article.cfm?id=296. Accessed February 2017.

National Cancer Institute (4 November 2015 reviewed). Tumor Markers. Available online at http://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/tumor-markers-fact-sheet. Accessed February 2017.

Thaker NG (5 September 2014 updated). CA 15-3. Medscape Reference. Available online at http://emedicine.medscape.com/article/2087491-overview. Accessed February 2017.

Graham LJ, Shupe MP, Schneble ED, et al. Current Approaches and Challenges in Monitoring Treatment Responses in Breast Cancer. Journal of Cancer. 2014; 5(1): 58-68. Published online 2014 Jan 5. doi: 10.7150/jca.7047

Molina R, Barak V, Duffy MJ, et al. Tumor Markers in Breast Cancer – European Group on Tumor Markers Recommendations. Available online at http://www.egtm.eu/professionals/breast_cancer. Accessed February 2017.

Chourin S, Georgescu D, Gray C, et al. Value of CA 15-3 Determination in the Initial Management of Breast Cancer Patients. Annals of Oncology. 2009:20(5):962-964. Published online 19 March 2009 doi:10.1093/annonc/mdp061.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

Check, W. (1998 July) Reaching agreement on tumor markers. CAP Today, In the News [On-line journal]. Available online at http://www.cap.org/captoday/archive/1998/julycover.html.

NCI (1998 April 27). Tumor markers. National Cancer Institute, Cancer Facts [On-line information]. Available online at http://cis.nci.nih.gov/fact/5_18.htm.

ACS (2000 July 19). Tumor Markers. American Cancer Society, Prevention and Early Detection [On-line information]. Available online through http://www.cancer.org.

AACC (2001 July 27) Use of Tumor Markers in Cancer Patients Leads to Better Detection, Decreasing Mortality. AACC Media Center, American Association for Clinical Chemistry [On-line press release]. PDF available for download at http://www.aacc.org/media/TumorMarkers.pdf.

ASCO (1996 May 17, adopted, revision every 3 years). CA 15-3 as a Marker for Breast Cancer. American Society for Clinical Oncologists, Clinical Practice Guidelines for the Use of Tumor Markers in Breast and Colorectal Cancer [On-line guidelines]. Available online at http://www.asco.org/prof/pp/html/guide/tumor/m_tumor10.htm.

(Revised 2008 December 08). Tumor Markers. American Cancer Society [On-line information]. Available online at http://www.cancer.org/docroot/PED/content/PED_2_3X_Tumor_Markers.asp?sitearea=PED. Accessed August 2009.

(Updated 2009 May) Tumor Markers. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/resources/print/TumorMarkers.pdf. Accessed August 2009.

Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER and Bruns DE, eds. 4th ed. St. Louis, Missouri: Elsevier Saunders; 2006, Pp 770-771.

Park, B et al. Preoperative CA 15-3 and CEA serum levels as predictor for breast cancer outcomes. Annals of Oncology 2008 19(4):675-681. Available online at http://annonc.oxfordjournals.org/cgi/content/full/19/4/675. Accessed September 2009.

Merck (2000). Cancer and the Immune System. The Merck Manual of Medical Information Home Edition, Section 15 Cancer, Ch 163 [On-line information]. Available online at http://www.merck.com/pubs/mmanual_home/sec15/163.htm.

Duffy, M. (1999). CA 15-3 and related mucins as circulating markers in breast cancer. Ann Clin Biochem [On-line journal]. Vol 36: 579-586. PDF available for download at http://www.leeds.ac.uk/acb/annals/annals_pdf/Sept%2099/ACB579.PDF.

Srirangam, S. and Harland, R. (2001). Management of Advanced Breast Cancer. Forum for Registrars In Surgical Training [On-line information]. PDF available for download at http://www.frist.org/asit/meetings/yearbook2001/BREAST%20CANCER.pdf.

(Revised 2012 October 18). Tumor Markers. American Cancer Society [On-line information]. PDF available for download at http://www.cancer.org/acs/groups/cid/documents/webcontent/003189-pdf.pdf. Accessed October 2012.

Thaker, N. et. al. (Updated 2012 May 24). CA 15-3. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/2087491-overview#showall. Accessed October 2012.

(© 1995-2012). Cancer Antigen 15-3 (CA 15-3), Serum. Mayo Clinic Mayo Medical Laboratories [On-line information]. Available online at http://www.mayomedicallaboratories.com/test-catalog/Overview/81607. Accessed October 2012.

Pagana and Pagana. Mosby’s Manual of Diagnostic and Laboratory Tests. Fourth Edition. Pg 142.

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