Periodic measurement of serum carcinoembryonic antigen and carbohydrate antigen 15-3 levels as postoperative surveillance after breast cancer surgery.
OBJECTIVE
Breast cancer surveillance guidelines do not recommend routine tumor marker testing after surgery, despite which it is still widely performed in Japan. We investigated the clinical utility of postoperative tumor marker testing in a series of Japanese patients, in view of the fact that all the studies to date have been non-Japanese.


METHODS
We retrospectively analyzed the lead time by periodic measurements of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA15-3) in 233 patients who underwent breast cancer surgery. Both tumor marker levels were measured every 3 months for the first 5 years, every 6 months for the next 5 years, then annually. Physical examination and chest X-ray were routinely done at the same time, and bone or computed tomographic scans were done if the tumor marker levels were elevated or clinical symptoms appeared.


RESULTS
In patients with recurrent disease, the mean lead times were -333.9 days for CEA and -210.6 days for CA15-3, respectively. Elevated tumor marker levels were found much later than recurrence.


CONCLUSIONS
Our results support the American Society of Clinical Oncology guidelines. Thus, the serial testing of tumor marker levels after breast cancer surgery may not be as beneficial as thought in Japan.
Nakamura
Toru
T
Division of Surgery, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Hamamatsu 430-8558, Japan.
Kimura
Taizo
T
Umehara
Yasuhiko
Y
Suzuki
Kenji
K
Okamoto
Kazuya
K
Okumura
Takuya
T
Morizumi
Sei
S
Kawabata
Toshiki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002272:Carcinoembryonic Antigen / Q000097:blood* / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood* / Q000378:metabolism; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000453:epidemiology; D009367:Neoplasm Staging; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1