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Open Access 01-12-2018 | Research

Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes

Authors: Michiko Imamura, Takashi Morimoto, Takashi Nomura, Shintaro Michishita, Arisa Nishimukai, Tomoko Higuchi, Yukie Fujimoto, Yoshimasa Miyagawa, Ayako Kira, Keiko Murase, Kazuhiro Araki, Yuichi Takatsuka, Koshi Oh, Yoshikazu Masai, Kouhei Akazawa, Yasuo Miyoshi

Published in: World Journal of Surgical Oncology | Issue 1/2018

Abstract

Background

Although the prognosis for operable breast cancers is reportedly worse if serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels are above normal, the usefulness of this prognosis is limited due to the low sensitivity and specificity; in addition, the optimal cutoff levels remain unknown.

Methods

A total of 1076 patients who were operated for breast cancers (test set = 608, validation set = 468) without evidence of metastasis were recruited, and their baseline and postoperative serum CEA and CA15-3 levels were analyzed. The optimal cutoff values of CEA and CA15-3 for disease-free survival (DFS) were 3.2 ng/mL and 13.3 U/mL, respectively, based on receiver operating characteristic curve and area under the curve analyses.

Results

The DFS of patients with high CEA levels (CEA-high: n = 191, 5-year DFS 70.6%) was significantly worse (p < 0.0001) than that of CEA-low patients (n = 885, 5-year DFS 87.2%). There was a significant difference in DFS (p < 0.0001) between CA15-3-high and CA15-3-low patients (n = 314 and n = 762, respectively; 5-year DFS 71.8 vs. 89.3%). Significant associations between DFS and CA15-3 levels were observed irrespective of the subtypes. Multivariable analysis indicated that tumor size, lymph node metastasis, tumor grade, and CEA (p = 0.0474) and CA15-3 (p < 0.0001) levels were independent prognostic factors (hazard ratio [HR] 1.520, 95% confidence interval [CI] 1.005–2.245 for CEA; HR 2.088, 95% CI 1.457–2.901 for CA15-3).

Conclusions

These findings suggest that CEA and CA15-3 levels might be useful for predicting the prognosis of patients with operable early breast cancer irrespective of the subtype. Serum levels at baseline may reflect tumor characteristics for metastatic potential even when these levels are within the normal ranges.

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Title: Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes
Authors: Michiko Imamura
Takashi Morimoto
Takashi Nomura
Shintaro Michishita
Arisa Nishimukai
Tomoko Higuchi
Yukie Fujimoto
Yoshimasa Miyagawa
Ayako Kira
Keiko Murase
Kazuhiro Araki
Yuichi Takatsuka
Koshi Oh
Yoshikazu Masai
Kouhei Akazawa
Yasuo Miyoshi
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2018
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-018-1325-6

At a glance: The STEP trials

Springer Medicine

Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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