The value of the tumor marker CA 15-3 in diagnosing and monitoring breast cancer. A comparative study with carcinoembryonic antigen

Abstract

To estimate the utility of the tumor-associated antigen CA 15-3 in the diagnosis of patients with breast cancer, this tumor marker was measured preoperatively in 1342 patients. This group included 509 patients with malignant disease (134 breast cancer patients and 375 patients with other malignancies not involving the breast) and 833 patients with benign surgical diseases (95 patients with fibroadenoma of the breast and 738 patients with other benign diseases). The results were compared with those obtained for carcinoembryonic antigen (CEA) in the diagnosis of breast cancer. The CA 15-3 level was above normal (25 U/ml) in 31% of the patients with breast cancer, in 22% of patients with other malignancies, and in 9% of patients with benign diseases. The CEA level was elevated in 26% of patients with breast cancer (more than 3 ng/ml). There was a good correlation of CA 15-3 levels with the tumor stage of breast cancer. Both CA 15-3 and CEA also were determined in 671 patients who had received initial curative surgery of breast cancer and who regularly attended our follow-up clinic. The CA 15-3 was found to be more sensitive than CEA in detecting recurrences of breast cancer. In the postcare period, carcinoma recurred in 205 patients. Of these, 73% had CA 15-3 concentrations above 25 U/ml; only 50% had CEA values above 3 ng/ml (P less than 0.000~).Although neither CA 15-3 nor CEA were sensitive enough for the screening and diagnosis of early breast cancer, CA 15-3 was significantly better than CEA in the detection of breast cancer metastases. Cancer 68:574-582,1991. Accepted for publication December I I , 1990. recognized first for colorectal carcinomas and then for solid tumors in generaL4 By contrast, the unraveling of the molecular structure of this tumor antigen not only did not progress but was even delayed as, in time, it became evident that there was no single CEA but rather a large family of more or less closely related glycoproteins. There is a general consensus now concerning the main properties of CEA.' These are its: beta electrophoretic mobility, solubility in perchlonc acid, molecular weight of 180,000 k 20,000 Daltons, absence of methionine, and single-polypeptide properties. Considering the low sensitivity of CEA in the early stages of breast cancer (6% to 18% depending on the cutoff value), this tumor marker is not suitable for ~creening.~-~ Several studies showed a correlation of CEA values with tumor size and mass and with the presence of lymph nodes or far metastases in breast cancer.6 The major utility of CEA lies in follow-up examinations for tumors." It is elevated in only one third of the cases with demonstrable 5 74

Correlation study of Carcino Embryonic Antigen & Cancer Antigen 15.3 in pretreated female breast cancer patients

“…The use of CA15.3 for early detection of metastases seems to be promising (12) and their use for measuring therapeutic response in metastatic disease is widely accepted (13).Women with resected breast carcinoma who received G-CSF (Granulocyte Colony Stimulating Factor) primed chemotherapy showed serum CA 15-3 elevation due to an increase in peripheral blood neutrophil number and induced neutrophil cytoplasmic MUC1 expression which was caused by G-CSF (14). The study by Safi et al (15) showed that CA15.3 was significantly better than CEA in the detection of breast cancer metastases. It is generally agreed that tumor markers in breast cancer patients are not a tool for primary diagnosis because of their low sensitivity and specificity (16).…”

Determination of carcinoembryonic antigen and cancer antigen values with the radioimmunoassay method in healthy females dogs

“…Generally said, obtained tumour markers from patients with breast tumours cannot be used for the primary diagnosis of disease because of low specificity and sensitivity (Lamerz et al 1993). Their use in early metastasis detection looks promising and is widely accepted (Safi et al 1991). Many studies have tried to evaluate the prognostic features of these markers (some by analysing serum, others by analysing tissue), but many of these studies analysed low numbers of patients or used short time periods for determination, and employed only one-way analysis (O'Hanlon et al 1995).…”

Serum CEA and CA 15-3 as prognostic factors in primary breast cancer

“…It is generally agreed that tumour markers in breast cancer patients are not a tool for primary diagnosis, because of their low sensitivity and specificity (Tondini et al, 1989;Fateh-Moghadam and Stieber, 1993;Lamerz et al, 1993). Their use for early detection of metastases seems to be promising (Lamerz et al, 1991;Stieber et al, 1992;Vizcarra et al, 1994;O'Hanlon et al, 1995) and their use for measuring therapeutic response in metastatic disease is widely accepted (Tondini et al, 1988;Dnistrian et al, 1991;Robertson et al, 1991;Safi et al, 1991). Many studies tried to assess the prognostic role of these tumour markers (some analysed in serum, some in tissue), but most of them had low patient numbers or short follow-up periods, and used only univariate analyses (Myers Tormey and Waalkes, 1978;Bezwoda et al, 1981;Mansour et al, 1983;Kallioniemi et al, 1988;Hammer et al, 1992;O'Hanlon et al, 1995).…”