Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Biomarkers, Tumor/blood* ; Breast Neoplasms/blood* ; Breast Neoplasms/drug therapy ; Breast Neoplasms/pathology* ; Breast Neoplasms/radiotherapy ; Breast Neoplasms/surgery ; Carcinoembryonic Antigen/blood* ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Middle Aged ; Mucin-1/blood* ; Neoplasm Invasiveness ; Neoplasm Staging ; Predictive Value of Tests ; Preoperative Care ; Prognosis ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis ; Treatment Outcome
Keywords
breast cancer ; CA 15-3 ; CEA ; prognosis ; tumor marker
Abstract
BACKGROUND: To investigate the association between tumor markers [cancer antigen 15-3 (CA 15-3) and carcinoembryonic antigen (CEA)] and clinicopathological parameters and patient outcomes in breast cancer.
MATERIALS AND METHODS: A total of 740 patients with stages I-III breast cancer had preoperative CA 15-3 and CEA concentrations measured. Univariate and multivariate analyses were used to investigate associations between marker concentration and clinicopathological parameters and patient outcomes.
RESULTS: Among 740 patients, elevated preoperative levels of CA 15-3 and CEA were identified in 92 (12.4%) and 79 (10.7%) patients, respectively. Tumor size (>5 cm), node metastases (> or =4), and advanced stage (> or =III) were associated with higher preoperative levels. Elevated CA 15-3 and CEA levels were associated with poor disease-free survival (DFS, P = 0.0014, P = 0.0001, respectively) and overall survival (OS, P = 0.018, P = 0.015) even in stage-matched analysis. Patients with normal levels of both CA 15-3 and CEA showed better DFS and OS than those with elevated group. In multivariate analysis, age (<35 years), tumor size (>2 cm), node metastases, estrogen receptor expression, and elevated CA 15-3 and CEA preoperative values were independent prognostic factors for DFS.
CONCLUSION: High preoperative CA 15-3 and CEA levels may reflect tumor burden and are associated with advanced disease and poor outcome. Measuring preoperative levels of CA 15-3 and CEA can be helpful for predicting outcomes