title: Sensitivity of CA 15-3, CEA and serum HER2 in the early detection of recurrence of breast cancer.
abstract: BACKGROUND
  The aim of this project was to investigate the sensitivity of CA 15-3, CEA and HER2 in the early diagnosis of metastatic breast cancer.
  
  
  METHODS
  Serial serum values of CA 15-3, CEA and HER2 were determined in 107 patients with recurrence after breast cancer. Fifteen of the patients had primary disseminated disease, nine patients only developed local recurrence during the follow-up period and the remaining 83 developed distant metastases.
  
  
  RESULTS
  In the group of patients with distant metastatic disease (n=83), elevated serum levels of CA 15-3 (>32.4 U/mL), CEA (>2.5 µg/L for non-smokers and >10 µg/L for smokers) and HER2 (>15 µg/L) were found in 49.4%, 38.6% and 32.5%, respectively, at the time of diagnosis of recurrence. CA 15-3 was significantly better than HER2 (p=0.027). The most sensitive combination was obtained using CA 15-3/CEA (60.2%) or CA 15-3/HER2 (57.8%). Combining all three tumour markers raised the sensitivity to 63.9%. In the subgroup of patients with tissue HER2+ tumours, the sensitivity of HER2 increased to 55.6%. The best combination in this group was CEA/HER2 (66.7%). In the subgroup of patients with tissue HER2- tumours, CA 15-3 was significantly better. The best combination was CA 15-3/HER2 or CA 15-3/CEA with a sensitivity of 55.8% and 59.6%, respectively.
  
  
  CONCLUSIONS
  The combination of several tumour markers enhances the sensitivity for detection of metastatic breast cancer. We recommend HER2 or the combination of CEA and HER2 in tissue HER2+ and CA 15-3 or the combination of CA 15-3 and CEA in tissue HER2-.
authors: Department of Clinical Biochemistry, Lilleb a lt Hospital, Vejle, Denmark. Annchristinapedersen@yahoo.dk
authors: Ann Christina
authors: AC
authors: Pedersen
authors: Patricia Diana
authors: PD
authors: Sørensen
authors: Erik Hugger
authors: EH
authors: Jacobsen
authors: Jonna Skov
authors: JS
authors: Madsen
authors: Ivan
authors: I
authors: Brandslund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood / Q000175:diagnosis*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D018270:Carcinoma, Ductal, Breast / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000097:blood*; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human