title: Diagnostic efficacy of CA 15-3 and CEA in the early detection of metastatic breast cancer-A retrospective analysis of kinetics on 743 breast cancer patients.
abstract: OBJECTIVE
  We investigated the diagnostic capacity of CEA and CA 15-3 kinetics for the early detection of metastatic disease in comparison to fixed cut off values.
  
  
  METHODS
  In a retrospective analysis, a total of 743 patients with early breast cancer and available baseline values of CEA and CA 15-3 were included. A reproducible increase of 100% of single or combined markers was considered as a strong indicator of metastatic disease.
  
  
  RESULTS
  187 patients developed metastatic disease and 556 remained disease-free. On the basis of tumor marker kinetics, we reached a specificity of >98% for both biomarkers and a sensitivity of 40.6% for CEA alone, 55.6% for CA 15-3 alone and 66.3% for the combination of both markers. Using fixed cut-off values (CEA: 4ng/mL, CA 15-3: 30U/mL) we ended up with a specificity of 86.3% and a sensitivity of 70.6% for the combination of CEA and CA 15-3. Using higher cut-off values (CEA: 6ng/mL, CA 15-3: 60U/mL) we reached a specificity of 96.9% and a sensitivity of 49.7% for the combination.
  
  
  CONCLUSIONS
  We conclude that the interpretation of these markers in follow-up using individual baseline values and kinetics leads to a significant superior profile of specificity and sensitivity.
authors.affiliation: Institute of Laboratory Medicine, Klinikum Großhadern, University Hospital, 81377 Munich, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Stieber
authors.affiliation: Institute of Laboratory Medicine, Klinikum Großhadern, University Hospital, 81377 Munich, Germany.
authors.forename: Dorothea
authors.initials: D
authors.lastname: Nagel
authors.affiliation: Institute of Laboratory Medicine, Klinikum Großhadern, University Hospital, 81377 Munich, Germany.
authors.forename: Irene
authors.initials: I
authors.lastname: Blankenburg
authors.affiliation: Department of Internal Medicine III, Klinikum Großhadern, University Hospital, 81377 Munich, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Heinemann
authors.affiliation: Gynecological Department, Helios Klinikum, 13125 Berlin-Buch, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Untch
authors.affiliation: Gynecological Department, Klinikum Landshut, 84034 Landshut, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Bauerfeind
authors.affiliation: Department of Internal Medicine III, Klinikum Großhadern, University Hospital, 81377 Munich, Germany. Electronic address: dorit.digioia@med.uni-muenchen.de.
authors.forename: Dorit
authors.initials: D
authors.lastname: Di Gioia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D001943:Breast Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D007700:Kinetics; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D009362:Neoplasm Metastasis / Q000175:diagnosis*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D018396:Mucin-1
keywords: Breast cancer; CA 15-3; CEA; Early detection; Increase; Kinetics; Metastatic disease; Recurrent disease; Tumor marker