Significance of serum carcinoembryonic antigen in metastatic breast cancer patients: A prospective study

Abstract

BACKGROUND Carcinoembryonic antigen (CEA) is an important serum tumour marker with a substantial role in diagnosis and monitoring of various solid tumours. About 36%-70% of breast cancers have elevated serum CEA. And the available studies show discrepancy in addressing the prognostic significance of CEA in advanced breast cancer. AIM To estimate the serum CEA level in our metastatic breast cancer patients and correlate it with response to treatment and clinical outcome. METHODS This was a prospective clinical study conducted on 50 metastatic breast cancer patients treated at breast clinic, with newly diagnosed metastatic breast cancer planned for palliative chemotherapy, targeted therapy, and hormonal treatment. We estimated the proportion of patients with elevated serum CEA level at baseline and after palliative treatment and also studied the association of serum CEA levels with known prognostic factors. The response to treatment was correlated with the serum CEA levels in the context of responders and non-responders. RESULTS The median pre-treatment and post-treatment CEA levels were 7.9 (1.8-40.7) ng/mL and 4.39 (1.4-12.15) ng/mL, respectively, in the whole study population ( P = 0.032). No statistically significant difference was seen in baseline serum CEA between responders and non-responders. Even in the luminal group, pre-treatment serum CEA was not a predictor of response, but post-treatment CEA was a significant predictor of tumour progression. In patients with liver and lung metastases, post-treatment CEA level difference was not statistically significant in both responders and non-responders though the values were higher in non-responders. Among those with bone metastases, 69.5% had elevated post-treatment serum CEA, and only 37.5% had elevated serum CEA in those with no bone metastases. CONCLUSION Elevated post-treatment serum CEA levels are associated with disease progression and poor response to therapy. Persistently elevated post-treatment serum CEA levels are significantly associated with bone metastases. Elevated serum CEA and hormonal status are significant predictors of treatment response.

The role of VEGF levels in the differentiation between malignant and benign breast tumor

“…The previous literatures stated that CA15-3 and CEA are two of the most widely utilized serum tumor indicators for breast cancer. Elevated levels of serum CEA are frequently observed in patients with metastatic and recurrent breast cancer [19] while the results obtained in the current work differ from previously reported articles in that the patients subjected to the study were early diagnosed and literatures regarding this stage of cancer reveled that both markers cannot be used in the deferential diagnosis due to their low sensitivity and specificity [20] which is also agreed with results obtained by Yang et al who found that elevated serum CEA levels are particularly noted in metastatic and recurrent disease [21] and Wang et al who demonstrated that serum CEA is less widely investigated as a prognostic factor than CA15-3 because of its poor sensitivity and specificity [22].…”

Exploring Biomarkers in Breast Cancer: Hallmarks of Diagnosis, Treatment, and Follow-Up in Clinical Practice

“…Li et al's meta-analysis further supported CEA's association with larger tumor size, lymph node involvement, and advanced tumor stage [139]. Yang et al's study demonstrated that increased CEA levels during therapy could predict a poor therapeutic response [140]. However, CEA is not exclusive to breast cancer and can be elevated in other conditions, necessitating its interpretation alongside other clinical factors.…”

The Circulating Biomarkers League: Combining miRNAs with Cell-Free DNAs and Proteins

“…Despite CA27.29’s greater sensitivity, its specificity compared to CA15-3 remains lower [ 180 ]. Meanwhile, the utility of CEA is questioned in metastatic breast cancer due to its elevated levels in a minor fraction of patients and a high false-positive rate among the general population, finding its primary clinical application in colorectal cancer, especially for early detection of liver metastases [ 181 , 182 ].…”