The Utility of Serum Tumor Markers CEA and CA 15-3 for Breast Cancer Prognosis and Their Association with Clinicopathological Parameters

Background: We aimed to evaluate the association of serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA 15-3) levels with clinicopathological parameters in patients with breast cancer (BC) and their efficiency for the prediction of recurrence.

Methods: The records of 482 female patients with breast cancer diagnosis followed in Medical Oncology and Radiation Oncology clinics of Kartal Dr. Lutfu Kirdar Education and Research Hospital were evaluated retrospectively.

Results: The median age of the patients was 49. CEA levels were significantly higher in postmenopausal patients (p = 0.022). There was no association between CEA and CA 15-3 levels and nodal involvement (p = 0.689, 0.379; respectively). CEA levels were significantly higher in hormone receptor-positive patients (p = 0.007). HER2 negative patients had significantly higher levels of CEA and CA 15-3 (p = 0.017 and 0.011, respectively). The evaluation of metastatic patients showed that CEA and CA 15-3 levels before metastasis were significantly elevated (p = 0.016 ve 0.008, respectively). There was no relation between the metastasis site and CEA, CA 15-3 levels (p = 0.936, 0.201, respectively). Receiver operating characteristic (ROC) analysis was performed to determine the role of CEA and CA 15-3 levels in the prediction of metastasis, and cut-off values were 1.39 ng/ml and 14.54 U/ml, respectively. Sensitivities of CA 15-3 and CEA levels were 82.1% and 88.3%; specificities were 47.3% and 46.2%, respectively.

Conclusions: CEA and CA 15-3 are useful as tumor markers for early diagnosis of metastases, and their elevations were associated with unfavorable clinicopathological parameters of breast cancer patients. Since these markers are considered a cheap and accessible way of predicting breast cancer prognosis, there is an increasing interest in the prognostic value of serum levels of tumor markers in recent years. More sensitive cut-off values for each marker are needed to be validated with further studies.