title: Use of CEA and CA15-3 to Predict Axillary Lymph Node Metastasis in Patients with Breast Cancer.
abstract: OBJECTIVE
  The clinical significance of preoperative serum levels of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) in breast cancer is controversial. The purpose of this study was to assess the clinical value of preoperative serum levels of CEA and CA 15-3 on the risk of axillary lymph node metastasis (ALNM) in patients with breast cancer.
  
  
  METHODS
  This retrospective study analyzed 1148 breast cancer patients whose preoperative CEA and CA 15-3 levels were measured. The association of these tumor markers and clinicopathologic parameters with ALNM was determined by univariate and multivariate analysis.
  
  
  RESULTS
  A median of 15 lymph nodes were removed. Seven hundred seventy-eight (67.8%) patients had node-negative disease and 370 (32.2%) had ALNM. Univariate analysis showed that tumor location (P = 0.024), stage (P = 0.001), grade (P < 0.001), lymphovascular invasion (LVI) (P < 0.001), CEA level (P < 0.001), CA15-3 level (P < 0.001), and breast cancer subtype (BCS) (P < 0.001) were significantly associated with ALNM. ALNM was present in 4.5% of patients with normal CEA and 11.6% of patients with elevated CEA. ALNM was present in 8.0% of patients with normal CA15-3 and 17.0% of patients with high CA15-3. Multivariate logistic regression analysis showed that tumor location, stage, grade, LVI, CEA, CA15-3, and BCS were significantly and independently associated with ALNM (P < 0.05 for all).
  
  
  CONCLUSIONS
  The probability of ALNM was greater in patients with elevated preoperative serum levels of CEA and CA15-3. CEA and CA15-3 appear to be independent predictors of ALNM in breast cancer.
authors.affiliation: 1. Xiamen Cancer Center, Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China;
authors.forename: San-Gang
authors.initials: SG
authors.lastname: Wu
authors.affiliation: 2. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China;
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: He
authors.affiliation: 3. Biobank, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China;
authors.forename: Hong-Yue
authors.initials: HY
authors.lastname: Ren
authors.affiliation: 4. Department of Basic Medical Science, Medical College, Xiamen University, Xiamen, People's Republic of China;
authors.forename: Li-Chao
authors.initials: LC
authors.lastname: Yang
authors.affiliation: 2. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China;
authors.forename: Jia-Yuan
authors.initials: JY
authors.lastname: Sun
authors.affiliation: 2. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China;
authors.forename: Feng-Yan
authors.initials: FY
authors.lastname: Li
authors.affiliation: 5. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Nasopharyngeal Carcinoma, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China.
authors.forename: Ling
authors.initials: L
authors.lastname: Guo
authors.affiliation: 2. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China;
authors.forename: Huan-Xin
authors.initials: HX
authors.lastname: Lin
keywords: Breast cancer; CA15-3.; CEA; axillary lymph node metastases