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Annals of Oncology Advance Access originally published online on November 23, 2007
Annals of Oncology 2008 19(4):675-681; doi:10.1093/annonc/mdm538
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© The Author 2007. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

breast cancer

Preoperative CA 15-3 and CEA serum levels as predictor for breast cancer outcomes

B.-W. Park1,4,*, J.-W. Oh1, J.-H. Kim1, S. H. Park1, K.-S. Kim2,4, J. H. Kim3,4 and K. S. Lee1

1 Department of Surgery
2 Department of Biochemistry & Molecular Biology
3 Department of Internal Medicine
4 Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea

* Correspondence to: Prof. B.-W. Park, Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul 120-752, South Korea. Tel: +82-2-2228-2121; Fax: +82-2-313-8289; E-mail: bwpark{at}yumc.yonsei.ac.kr

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 (≥4), and advanced stage (≥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.

Key words: breast cancer, CA 15-3, CEA, prognosis, tumor marker

Received for publication August 24, 2006. Revision received October 4, 2007. Accepted for publication October 22, 2007.


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