Clinical relevance of Ca 15-3 in comparison to other tumor markers in diagnosis and follow up observations of breast cancer patients

In order to verify the efficiency of the tumor markers CA 15.3 and CA 549 in the follow-up of breast cancer patients, it was necessary first to check the cutoff levels of each tumor marker in women with an increased age-related risk, but with no evidence of disease. From 132 serum samples in this age group, we confirmed the CA 549 cutoff level of 12.1 U/ml. However, the cutoff of CA 15.3 was 34 U/ml, which is higher than previously reported in the literature. Fifty-two breast cancer patients with or without metastases at the time of entry into the study were followed for 2 to 3 years with both tumor markers. The sensitivity, specificity and the test efficiency for the presence of metastases were analyzed with each tumor marker. Taking into account the different cutoff levels, we concluded that both tumor markers can be used independently to follow the clinical situation of patients. In several cases an increase in both tumor markers was observed before a clinical diagnosis of metastases could be made. Combination of these two tumor markers gave no more significant information about the patient's clinical situation than each tumor marker alone.

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Study of serum tumor markers CEA, CA 15.3 and CA 27.29 as diagnostic parameters in patients with breast carcinoma

The International Journal of Biological Markers ◽

10.1177/172460089501000105 ◽

1995 ◽

Vol 10 (1) ◽

pp. 24-29 ◽

Cited By ~ 13

Author(s):

L. Rodríguez De Paterna ◽

F. Arnaiz ◽

J. Estenoz ◽

B. Ortuño ◽

E. Lanzós

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tumor Markers ◽

Serum Levels ◽

Breast Diseases ◽

Breast Cancer Patients ◽

Ca 15.3 ◽

Combined Use ◽

Malignant Breast

Serum levels of CEA, CA 15.3 and CA 27.29 were measured during the follow-up of 499 breast cancer patients. Studies included three different groups of women: 82 blood donors free of disease, 42 patients with non-malignant breast diseases and 499 breast cancer patients. After the determinaion of cut-off values, serum levels of tumor markers did not show significant elevations in benign breast diseases. On the basis of our results CA 15.3 (sensitivity = 57%; accuracy = 87%) was the most effective marker, CA 27.29 (sensitivity = 62%; accuracy = 83%) was the most sensitive and CEA (sensitivity = 45%; accuracy = 81%) was the least sensitive and effective marker. The combined use of markers was evaluated by step-wise logistic regression analysis. The regression coefficients showed that CA 15.3 (coeff. = 2.97) and CA 27.29 (coeff. = 1.46) were suitable for the detection of possible metastases during follow-up. Finally, we studied the relationship between pT, pN, pM and circulating levels of CA 15.3 and CA 27.29.

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Postoperative Follow-Up of Breast Cancer Patients: Overview and Progress in the Use of Tumor Markers

Tumor Biology ◽

10.1159/000030129 ◽

2000 ◽

Vol 21 (4) ◽

pp. 235-248 ◽

Cited By ~ 25

Author(s):

Andrea Nicolini ◽

Angelo Carpi

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tumor Markers ◽

Breast Cancer Patients

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Serum CEA and PHI as Tumor Markers in the Follow Up of Breast Cancer Patients

Protides of the Biological Fluids ◽

10.1016/b978-0-08-031739-7.50176-2 ◽

1985 ◽

pp. 707-710

Author(s):

R. PAULICK ◽

H. CAFFIER ◽

M. PAULICK

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Tumor Markers ◽

Breast Cancer Patients ◽

Serum Cea

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Tumor markers in metastatic breast cancer: High tumor specificity within the reference range

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.10554 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 10554-10554 ◽

Cited By ~ 2

Author(s):

P. Stieber ◽

D. Nagel ◽

V. Heinemann

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Cancer Patients ◽

Tumor Markers ◽

Metastatic Breast ◽

Breast Cancer Patients ◽

Healthy Individuals ◽

False Negatives ◽

Baseline Values

10554 In breast cancer as well as in other solid tumors all “tumor markers” actually available are not tumor specific but can be measured in different extent also in all healthy individuals. By consequence any fixed cut off value used must lead to false positive and negative test results for the individual patient. In a retrospective analysis we investigated the diagnostic capacity of CEA and CA 15–3 for the early detection of metastatic breast cancer comparing the use of fixed cut off values with kinetics. After complete removal of the tumor (R0 resection) breast cancer patients reach 4 weeks after the end of adjuvant radio/chemotherapy their individual “normal” values: these median values for CEA (Abbott, AxSYM) and CA 15–3 (Roche, Elecsys) are comparable to the medians of healthy individuals (CEA: 1 ng/ml; CA 15–3: 13 U/ml). A reproducible increase of 100% of at least one of these markers was postulated as indication for metastatic disease. A total of 899 breast cancer patients with a non metastatic primary tumor and available individual baseline values after primary treatment was included. Of these 717 remained disease-free and served as control group, whereas 182 patients developed metastatic disease during follow-up. On this basis we reached a specificity of more than 98% for both biomarkers and a sensitivity of 16% for CEA alone, 24% for CA 15–3 alone and another 25% for both markers resulting in 66% true positives or 34% false negatives. Using fixed cut off values (CEA: 4 ng/ml and CA 15–3: 30 U/ml) we ended up with 19% false positives (specificity 81%) and a sensitivity of 9% for CEA, 30% for CA 15–3 and another 27% for both resulting also in 34% false negatives. Using higher cut off values where the probability of metastatic breast cancer is increased (CEA: 6 ng/ml and CA 15–3: 60 U/ml) we reached a specificity of 96% and a sensitivity of 10% for CEA and 19% for CA 15–3, another 14% for both, resulting in 57% false negatives. We conclude that the interpretation of these markers in follow-up care using individual baseline values and kinetics leads to a significant superior profile of specificity and sensitivity. No significant financial relationships to disclose.

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