MBC Matters: Understanding Blood Test Results

Research has shown that self-advocates are more likely to receive better care and have their medical questions and problems addressed. We're excited to bring you this episode, focusing on a crucial aspect of managing metastatic breast cancer—understanding blood test results. Blood tests are vital in cancer care, offering insights into our health, monitoring treatment effectiveness, and guiding our medical team's decisions. However, interpreting these results can be challenging. Joining us today is Dr. Alfredo Torres, who will help us break down the common types of blood tests, explain what the numbers mean, and discuss their impact on your treatment plan. Knowing how to interpret these results can empower you to advocate for yourself more effectively and enhance your overall care. Whether you're newly diagnosed or have been living with metastatic breast cancer for some time, this episode aims to empower you with valuable knowledge. Grab a cup of our favorite beverage and get comfortable as we dive into the mysteries of blood test results together.

Types of Blood Tests for Cancer

What do blood tests show?

In a broad sense, a blood test shows changes in your body. Blood test results don’t show a complete picture. Instead, they’re a kind of snapshot. After seeing that snapshot, your provider may do other blood tests to get a closer view. Here’s a glimpse of what your healthcare provider may see with blood tests:

• The tests show if your blood is working as it should. For example, your red blood cells carry oxygen throughout your body. A blood test may show you have low red blood cell levels (anemia). If healthcare providers look at your cells under a microscope, they may see your red blood cells are larger than normal or shaped differently than normal red blood cells. These differences may be signs of blood disorders or blood cancers.

• They show if you have normal levels of enzymes and electrolytes. Enzymes are proteins that help speed up the chemical reactions that build up and break down substances in your body. Electrolytes do several things, such as helping your body regulate chemical reactions and maintaining the balance between fluids inside and outside your cells.

What are the most common blood tests?

• Complete blood count (CBC).

  looks at whether your blood has normal numbers of different types of blood cells. For example, it can show if you are anemic (have a low number of red blood cells), if you could have trouble with bleeding (due to a low number of blood platelets), or if you are at increased risk for infections (because of a low number of white blood cells). This test could be repeated regularly during treatment, as many cancer drugs can affect blood-forming cells of the bone marrow

• Blood chemistry tests (LFT, ALT/AST)

  can help find if some of your organs, such as the liver or kidneys are not working as well. For example, if cancer has spread to the bones, it might cause higher than normal levels of calcium and alkaline phosphatase. If breast cancer spreads to the liver, it can sometimes cause high levels of liver function tests, such as aspartate aminotransferase (AST) or alanine aminotransferase (ALT). Breast cancer does not spread to the kidneys, but if your bloodwork shows your kidneys are not working well, certain chemo drugs, like cisplatin, might not be used.

• Tumor marker blood tests

  Breast cancer cells sometimes make substances called tumor markers that can be found in the blood. For breast cancer that has spread to other organs, tumor markers that might be checked include carcinoembryonic antigen (CEA), cancer antigen 15-3 (CA 15-3), and cancer antigen 27-29 (CA 27-29). Blood tests for these tumor markers are not used by themselves to diagnose or follow breast cancer.

What does a complete blood count (CBC) test show?

This is the most common blood test that includes several specialized tests. CBC tests:

• Count and measure your red blood cells, white blood cells and your platelets. A CBC test includes a hematocrit test that measures the percentage of red blood cells in your blood.

• Measure your hemoglobin levels.

• Measure variations in your red blood cells’ size and volume with an RDW blood test (RDW stands for “red blood cell distribution width”).

• Measure the average size of your red blood cells with a mean corpuscular volume (MCV) test.

What does a basic metabolic panel show?

A basic metabolic panel (BMP) measures several substances in your blood. Healthcare providers use BMPs to evaluate your overall health and screen for or monitor health issues. A BMP may include a:

• Blood glucose test: Screens for diabetes.

• Calcium blood test: Checks to make sure you have appropriate levels of calcium, a mineral that helps with many of your body’s functions.

• Blood urea nitrogen (BUN) test: Measures the amount of urea, a waste product that passes through your kidneys. BUN tests show the amount of urea nitrogen in your kidneys.

• Creatine kinase (CK) test: Screens for a waste product your muscles produce. High CK levels may be a sign of injured or damaged muscles.

• Sodium levels.

• CO2 blood test: Measures the amount of bicarbonate in your blood. This test detects carbon dioxide.

• Serum potassium test: Measures potassium levels. Potassium supports your heart, nerve and muscle function and your metabolism.

• Chloride blood test: Checks on chloride, an electrolyte that helps keep your body fluids and acids balanced.

• Globulin blood test: Measures how much of this protein your liver produces.

What does a comprehensive metabolic panel show?

Comprehensive metabolic panels (CMP) include all the blood tests done as part of a basic metabolic panel. Additional blood tests include:

• Albumin blood test: Albumin is a protein in your blood plasma. This test checks on kidney and liver function.

• Alanine transaminase (ALT): Healthcare providers use this test to assess liver health.

• Alkaline phosphatase (ALP): High levels of this enzyme may indicate liver disease or certain bone disorders.

• Ammonia levels: Blood tests will show the amount of ammonia in your blood. High ammonia levels may be a sign of liver and kidney damage.

• Bilirubin blood test: Bilirubin is a substance in your liver’s bile. Too much bile in your blood may be a sign of liver issues.

• Aspartate transferase: Sometimes called AST, this test measures the amount of the enzyme aspartate transferase in your blood. Providers use this test to assess liver health.

What does an electrolyte panel show?

Electrolytes are minerals in your blood. Imbalance with electrolytes may be a sign of issues with your heart, kidneys or your lungs. An electrolyte panel includes all electrolyte tests in BMPs and CMPs. Additional electrolyte levels tested include magnesium and anion gap. Magnesium supports your brain, heart and muscles. Anion gap tests check the acid-base balance in your blood.

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Meet the Guest of the Episode

Alfredo Torres, MD

Dr. Torres is the Associate Chief Medical Officer at NYCBS. He is board certified in Internal Medicine, Medical Oncology, and Hematology.

He is fluent in English and Spanish.

Dr. Torres received his Medical Degree from Universidad de Carabobo, Venezuela. He completed his residency in Internal Medicine through the prestigious Harrington Program from Jackson Memorial Hospital/University of Miami. In addition, Dr. Torres achieved his Fellowship in Medical Oncology and Hematology at Jackson Memorial Hospital/the University of Miami.

Dr. Torres has published numerous studies in Hematology and Oncology in peer-reviewed medical journals. He was also a grant recipient from the Florida Breast Cancer Foundation. Dr. Torres is currently a member of several prestigious organizations including the American College of Physicians, the American Society of Clinical Oncology, the American Society of Hematology, and the Community Oncology Alliance.

Dr. Torres is currently a Clinical Assistant Professor of Medicine at Stony Brook University Hospital. He has also served on the Chemotherapy committee at Jackson Memorial Hospital and he is currently a leader in the chemotherapy committee at NYCBS.

His interests include lung cancer, gastrointestinal cancer, gynecological cancer, prostate cancer, and lymphomas.

Credentials:  Associate Chief Medical Officer , M.D.
Education & Training
Residency:    Jackson Memorial Hospital
Medical School:    Universidad de Carabobo