A3. 抽血检查乳癌指数(CA 15.3)，对确诊或覆诊有帮助吗？

游子觉医生答:

    有些医生会在最初确诊或治疗后覆诊时，替病人抽血检查一种名为 CA15.3 的乳癌指数。这指数的灵敏度低，对整体治疗或跟进没有多大用处。美国临床肿瘤学会 (American Society of Clinical Oncology) 发出的指引(1)，不建议医生在确诊或一般定期覆诊时使用上述检查; 至于其他检血或扫描检查，除非病人有可疑病征，否则亦不建议在一般定期覆诊时安排。 (“The use of CBCs, chemistry panels, bone scans, chest radiographs, liver ultrasounds, computed tomography scans, [18F]fluorodeoxyglucose-positron emission tomography scanning, magnetic resonance imaging, or tumor markers (carcinoembryonic antigen, CA 15-3, and CA 27.29) is not recommended for routine breast cancer follow-up in an otherwise asymptomatic patient with no specific findings on clinical examination.”)

    话虽如此，很多病人心理上仍然很依赖这类所谓癌指数检查，常要求医生安排。

(1). Khatcheressian JL, Wolff AC, Smith TJ,et al. American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol. 2006;24:5091-5097.