Measurement of prostate-specific antigen in detection of benign or malignant breast disease in women

Abstract

Summary Using a highly sensitive chemiluminescent enzyme immunoassay, we have evaluated the measurement of serum prostatespecific antigen (PSA) as a potential diagnostic test for differentiation between women with breast cancer and those with benign breast disease. In a controlled study consisting of 284 women with well-documented patient files and matched for age and long-term place of residence, serum samples collected from 90 women with histologically confirmed breast cancer, 94 women with benign breast disease and 100 controls were analysed. Serum total PSA levels in benign breast disease and cancer patients are not statistically different from those of healthy controls. Total PSA levels decrease with age in normal controls and breast cancer patients but not in those with benign breast disease. The total PSA concentration decreases after menopause in healthy women, though not in patients with breast cancer or benign breast disease. Total PSA bore no relation to the histological type or grade of the tumour or the disease stage of the breast cancer patients. In benign breast disease, all mastopathy patients had normal total PSA, whereas elevation of the values was observed in 7% of fibroadenoma patients. Our results show that serum total PSA cannot be used to distinguish between healthy women and/or women with breast cancer or benign breast disease.

Measurement of serum total and free prostate-specific antigen in women with colorectal carcinoma

“…The cut-off value in breast cancer diagnosis for total PSA is 30 ng ml 71 (Borchert et al, 1997;Romppanen et al, 1999) which is 10 times lower than the value we found. This discrimination may be due to the difference in the sensitivities of PSA assays.…”

“…Another study revealed serum total PSA concentrations to be significantly lower in women with breast cancer than women with benign breast disease and no significant difference was found between cancer patients and normal women; free PSA levels showed no difference in the groups (Borchert et al, 1997). In another study, no significant difference in serum total PSA levels was found between breast cancer patients and women with benign breast disease or healthy women (Romppanen et al, 1999).…”

“…In one study serum total PSA levels were found to decrease significantly with ageing in both healthy women and women with breast cancer (Romppanen et al, 1999). However, in another study no significant correlation was found between serum total PSA levels and age in normal women while a negative correlation was demonstrated in women with breast cancer (Borchert et al, 1997).…”

Serum total PSA and free PSA in breast tumors

“…This could be attributed to disrupted hormonal balance in such cases leading to aberrant expression of hormone dependent genes like PSA which is normally under hormonal control and upregulated by androgens and progesterone [5,27,28]. Many other authors have, however, failed to depict any such rise in PSA level in breast tumor cases [9,10]. However, we observed no significant difference in total PSA and free PSA level in the study population when their menstrual status was considered exhibiting no association of the parameters with the menstrual status.…”

“…Various authors have documented that free form is the predominant molecular form of PSA in breast cancer whereas the bound form is more prevalent in benign breast diseases and healthy females [7,8]; while many others have failed to establish any such observations regarding the various molecular forms of PSA in breast cancer and benign breast diseases [9,10]. Moreover, a fall in serum PSA levels after surgical removal of tumor tissue has been observed in some studies, while others have failed to observe any such change in serum level of PSA after surgery [8,11].…”