CEA and CA 15-3 in primary and recurrent breast cancer.
To evaluate CA 15-3, a new breast cancer associated antigen, and to compare it with carcinoembryonic antigen (CEA), all patients presenting with breast cancer had preoperative and serial (3-monthly) postoperative levels measured. Of 124 patients with primary breast cancer, 23% had an elevated CA 15-3 (greater than 25 units/ml) while 11% had an elevated CEA (greater than 5 ng/ml) (p = not significant). Neither marker was an indicator of spread to regional lymph nodes in primary breast cancer. In 45 recurrences of breast cancer, CA 15-3 was elevated at the time of first recurrence in 58% while CEA was elevated in 47% (p = not significant). Of 17 patients with locoregional recurrence alone, none had a CA 15-3 above 40 units/ml while 11 of 12 with synchronous locoregional and distant recurrence had a CA 15-3 level greater than 40 units/ml (chi 2: 21.36, p less than 0.0001). This study shows that CA 15-3, like CEA, is of little clinical value in primary breast cancer. CA 15-3, however, is an accurate indicator (overall accuracy, 97%) of synchronous distant metastases in patients with locoregional recurrence from breast cancer. This information has important implications for further investigation and management of such patients.
O'Dwyer
P J
PJ
Department of Surgery, University College Dublin, Woodview, Belfield, Ireland.
Duffy
M J
MJ
O'Sullivan
F
F
McDermott
E
E
Losty
P
P
O'Higgins
N J
NJ
D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011237:Predictive Value of Tests
D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen