The sensor team at the Los Alamos National Laboratory has developed a waveguide-based optical biosensor for the detection of biomarkers associated with disease. We have previously demonstrated the application of this technology to the sensitive detection of carcinoembryonic antigen in serum and nipple aspirate fluid from breast cancer patients. In this publication, we report improvements to this technology that will facilitate transition to a point-of-care diagnostic system and/or robust research tool. The first improvement involved replacing phospholipid bilayers used for waveguide functionalization with self-assembled monolayers. These thin films are stable, specific, and robust silane-based surfaces that reduce nonspecific binding and enhance the signal to background ratio. Second, we have explored four different fluorescent labeling paradigms to determine the optimal procedure for use in the assay. Labeling the detector antibody with an organic dye (AlexaFluor 647) in the hinge region allows for unusual signal enhancement with repeat excitation (at 635 nm) in our assay format, thereby facilitating a better signal resolution at lower concentrations of the antigen. We have also labeled the detector antibody with photostable quantum dots through either the amine groups of lysine (Fc, NH) or using a histidine tag in the hinge region of the antibody (Hinge, H). Both labeling strategies allow for acceptable signal resolution, but quantum dots show much greater resistance to photobleaching than organic dyes.