The distribution of carcinoembryonic antigen in breast carcinoma diagnostic and prognostic implications

Abstract

Carcinoembryonic antigen (CEA) has been shown to be a useful tumor marker in patients with breast carcinoma. The unlabeled antibody immunoperoxidase technique was used to localize CEA in 93 cases of primary breast carcinoma, 15 cases of atypical duct papillomatosis, and 4 cases of duct papilloma. Normal breast epithelium and breast epithelium in fibrocystic disease did not stain positively for CEA. Twenty‐four of 27 (88%) intraductal carcinomas, and 47 of 69 (68%) infiltrating duct carcinomas were CEA positive. In contrast, only 5 of 21 (23%) in situ lobular carcinomas and 8 of 24 (33%) infiltrating lobular carcinomas were positive for CEA. All 15 cases of atypical epithelial papillomatosis were negative, whereas 1 of the 4 cases of duct papilloma exhibited microscopic foci of weak CEA positivity. There was a trend for infiltrating duct carcinomas, 3 cm in diameter or smaller, staining strongly positive for CEA, to be associated with synchronous axillary lymph node metastases (P = 0.09). Tumor heterogeneity was a constant feature of CEA staining with positivity varying from region to region and even from cell to cell. Positive immunohistochemical staining for CEA may play an adjunctive role in discriminating intraductal carcinoma from atypical papillary ductal proliferations.

Tissue carcinoembryonic antigen and oestrogen receptor status in breast carcinoma: an immunohistochemical study of clinical outcome in a series of 252 patients with long-term follow-up

“…Several studies suggested that its evaluation could provide valuable clinical information in patients affected by breast carcinoma (Molina et al, 1995), but data are still not conclusive (ASCO, 1996). CEA expression has also been studied with immunohistochemical methods on large series of breast carcinomas, but its meaning as a prognostic marker remains unclear (Walker, 1980;Kuhajda et al, 1983;Mansour et al, 1983; Eskelinen et al, 1992). Discrepant results are indeed reported in the literature: this may be partly because of the wide variety of antibodies used, some of which may not be completely specific for the CEA molecule and cross-react with other molecules.…”

Carcinoembryonic antigen immunocytochemistry in primary breast cancer

“…However, on reviewing the literature they found that the reported incidence ranged from 1.6% to 83% of breast carcinomas. 8 Reasons that have been suggested to explain this wide range include tumor heterogeneity, immunologically different CEA antisera, and/or the hetero- …”

CEA, PSA and Other Biomarkers in Nipple Fluid for Early Cancer Detection

“…However, available assays did not have adequate sensitivity to detect telomerase in our small quantities of material. In a second collaboration with Matritech, a biotechnology firm focusing on nuclear matrix proteins (23,24), NAF samples showed differing patterns of concentration and distribution of diverse proteins. Analysis was made of a breast cancer-associated nuclear matrix protein developed by Matritech.…”

“…CEA is elevated in serum of 40-50% of patients with metastatic breast cancer, and is used both in initial tumor staging and monitoring of response to treatment (22). CEA is detectable immunohistochemically in breast cancer cells, whereas most of the normal and benign tumor tissues stain weakly or not at all with anti-CEA antibodies (23). CEA has been detected in foamy macrophages and intraluminal material of nonneoplastic lobules and ducts adjacent to the CEA-positive cancerous tumors (23.…”