Importance of CEA and CA 15-3 during disease progression in metastatic breast cancer patients

The aim of this study analysis was to determine the correlation between elevation of CEA and/or CA 15-3 and disease progression of metastatic breast cancer. Materials and Methods: We investigated 119 breast cancer patients who had metachronous metastases. We evaluated levels of CEA and CA 15-3 at the time of first recurrence and at every further disease progression (PD). Results: Increasing value levels of CEA as well as CA 15-3 were found in correlation to the number of PD with a continuously increasing sensitivity in the detection of metastatic disease for each marker alone and especially in combination. At the first time of distant metastasis, CEA and CA 15-3 were above the 95th percentile of healthy individuals in 53.5% and 71.8%, respectively. During disease progression the sensitivities were: 1st PD for CEA/ CA 15-3 54.1%/ 70.6%, 2nd PD 63.5%/ 81.2% and 3rd PD 68.6%/ 90%. Conclusion: There is a correlation between elevation of CEA and/or CA 15- 3 and disease progression, in breast cancer patients. Breast cancer remains the most common malignancy affecting women in industrialized countries. It is estimated that 4.4 million women who have had breast cancer diagnosed within the last 5 years are alive. Because of the growing incidence rates, there would be around 1.4 million new cases in 2010 worldwide (1). Cancer antigen (CA) 15-3 in combination with the carcinoembryonic antigen (CEA) are the most relevant tumor markers in breast cancer (2-4). Elevated serum levels of CEA and CA 15-3 were found in 13% and 19% of breast cancer patients at primary diagnosis, respectively. There is a correlation between both tumor markers and tumor size and nodal involvement, with significantly higher concentrations in patients with larger tumors or in patients with nodal involvement. Due to their low sensitivity at primary diagnosis, they cannot be recommended for screening, but they are useful tools in follow-up and therapy monitoring. In follow-up, CEA and CA 15-3 have been shown to detect 40-60% of recurrences before clinical or radiological evidence of disease with a lead-time between 2 and 18 months. Simultaneous use of both serum markers allows early diagnosis of metastases in up to 60-80% of patients with breast cancer (4-9). The aim of our retrospective analysis was to describe the importance of CEA and CA15-3 in metastatic breast cancer and to show an association between elevation of tumor markers and disease progression.