Prognostic value of CA 15.3 kinetics for metastatic breast cancer

Abstract Purpose: Novel molecular characterization of breast cancer with cellular markers has allowed a new classification that offers prognostic value. This study investigates the prognostic value of the Bioscore among non-metastatic breast cancer patients with respect to disease free survival (DFS).Methods: This study included 317 patients with non-metastatic surgically treated breast cancer; they were identified in the period from January 2015 to December 2018 at Clinical Oncology Department of Assiut University Hospital. Many variables were used; pathologic stage (PS), T stage (T), nodal stage (N), grade (G), estrogen receptor (ER), progesterone receptors (PR), and human epidermal growth factor receptor (HER2) status. Univariate & two multivariate analyses were performed to identify which of these variables are associated with disease-free survival (DFS). Results: The only significant factors in the Univariate analysis were PS3, T2, T3, T4, N3, G2, G3, ER -ve, PR -ve, and HER2 –ve. The factors which were significant in the first multivariate analysis; PS3, G3, ER –ve, and in the second one were; T2, T4, N3, G3, and ER –ve. Two sets of models were built to determine the utility of combining variables. Models incorporating G and E status had the highest C-index (0.72) for T+N + G + ER in comparison with (0.69) for (PS+ G + ER) and the lowest AIC (953.01) for T + N + G + E and (966.9) for PS + G + E. Conclusions: This study confirms the prognostic significance of bioscore in non-metastatic breast cancer in concerning DFS.

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Prognostic Value of CA 15.3 Kinetics for Metastatic Breast Cancer

The International Journal of Biological Markers ◽

10.1177/172460080201700403 ◽

2002 ◽

Vol 17 (4) ◽

pp. 231-238 ◽

Cited By ~ 14

Author(s):

B. De La Lande ◽

K. Hacene ◽

J.-L. Floiras ◽

N. Alatrakchi ◽

M.-F. Pichon

Keyword(s):

Breast Cancer ◽

Lead Time ◽

Prognostic Value ◽

Cox Model ◽

Metastatic Breast ◽

Control Group ◽

Breast Cancer Patients ◽

Ca 15.3 ◽

Kaplan Meier ◽

Kinetics Of

Up to 80% of breast cancer patients developing metastases have high levels of CA 15.3. We studied the prognostic implications of CA 15.3 kinetics in 119 patients before and at first metastasis by univariate and multivariate statistics. At first metastasis, CA 15.3 was elevated in 82.4% of patients, with a lead time (median 162 days) in 42.0% of them. Kaplan-Meier analysis showed overall survival (median 1477 days) to be significantly related to estrogen receptor (ER) and progesterone receptor (PgR) status (p=0.0001) and tumor size (p=0.025). The interval between diagnosis and first abnormal CA 15.3 (p=0.0001), the CA 15.3 concentration (p=0.013), and the presence or absence of a lead time (p=0.001) also had prognostic value. ER and PgR status (p=0.0005 and p=0.0103, respectively), metastasis-free interval (p=0.0003), existence of a CA 15.3 lead time (p=0.0028), and days from diagnosis to first abnormal CA 15.3 (p=0.0055) entered in the Cox model. After first metastasis (median survival 573 days), ER and PgR status (p=0.0001 and p=0.0004, respectively), existence of a lead time for CA 15.3 (p=0.0138), and the concentration of first abnormal CA 15.3 (p=0.0145) had individual prognostic value. In the Cox model ER status (p=0.0001), nodal status (p=0.0191), existence of a lead time for CA 15.3 (p=0.0033), days from diagnosis to first abnormal CA 15.3 (p=0.0132), and concentration of first abnormal CA 15.3 (p=0.0320) were found to be independent prognostic variables. Compared to a matched historical control group that was not monitored by CA 15.3 assaying (n=140), the study group had a significantly longer survival after the first metastasis (p=0.0005). In conclusion, the kinetics of CA 15.3 before the first metastasis is of prognostic value. When associated with 18-fluorodeoxyglucose imaging, serial CA 15.3 assays may help to implement early treatment of metastases.

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Serological Markers for Metastatic Breast Cancer

Disease Markers ◽

10.1155/1993/384695 ◽

1993 ◽

Vol 11 (5-6) ◽

pp. 217-223 ◽

Cited By ~ 8

Author(s):

J. S. Y. Ng ◽

C. M. Sturgeon ◽

J. Seth ◽

G. M. Paterson ◽

J. E. Roulston ◽

...

Keyword(s):

Breast Cancer ◽

Metastatic Breast Cancer ◽

Soft Tissues ◽

Metastatic Breast ◽

Serum Markers ◽

Response To Treatment ◽

Regional Lymph Nodes ◽

Ca 15.3 ◽

Reference Limit ◽

Progression Of Disease

Three serum markers, TPS, CA 15.3 and CEA, were used to monitor the response to treatment of 20 patients with metastatic breast cancer. At the time of the first evidence of metastases or at the time of progression of known metastatic disease, 84% of TPS values were above the reference limit, as compared to 74% for CA 15.3 and 84% forCEA. If the treatment instituted was effective, 60% of TPS values showed an early (within 2 or 3 weeks after commencement or change of therapy) reduction in level against only 27% of CA 15.3 and 27% of CEA levels. This suggests that TPS provides a more sensitive and earlier predictor of therapeutic response. In patients with clinical evidence of further progression of disease while on therapy , 86% ofTPS values showed persistent elevation or increase, as compared to 71 % of CA 15.3 levels and only 36% ofCEA levels. It was also noted in these patients that TPS values rose earlier than either CA 15.3 or CEA. This indicates that TPS is a more reliable predictor of response to treatment than the other two markers. In addition, we found that, at the time of presentation, in women who had visceral metastases (liver, lung, or brain alone or in combination), 87% ofTPS values were raised, as compared to 80% of CA 15.3 and 73% of CEA values. In women who had bone and soft tissue metastases at presentation, 75% ofTPS values were elevated, against 50% ofCA 15.3 and 75% of CEA values. We also noted that in patients without raised TPS levels, the sites of subsequent disease progression were limited to bones, regional lymph nodes, skin and soft tissues.

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