Relationship Between Tumor Markers CEA and CA 15-3, TNM Staging, Estrogen Receptor Rate and MIB-1 Index in Patients with pT1-2 Breast Cancer

Abstract

Background: The aim of this study was to analyze whether a correlation exists between preoperative serum tumor markers (STM) CEA and CA 15-3, age of the patients, TNM staging, hormone receptor (ER, PgR) status, and MIB-1 proliferation index in patients who underwent surgery for primary breast cancer (BC). Patients and Methods: Data regarding a series of 255 consecutive women (median age 60 years, range 30-85) with pT1-2 BC were reviewed, while patients with confirmed pT3-4 BC were excluded. All patients underwent preoperative CEA and CA 15-3 serum levels measurement, and the removed tissue was routinely processed for the detection of ER, PgR, and MIB1 index. Results: Serum CEA and CA 15-3 measurements were above the cut-off in 44 (17.2%) and 75 (29.0%) patients, respectively, and the overall sensitivity of STM was 37.6%. A strong correlation between ER and PgR rate (R=0.77) was found. There was no relationship (p=NS) between age of the patients, size (R=0.08), MIB-1 index (R=0.11), and both ER (R=0.01) and PgR (R=0.03) rate. No linear correlation was found between both CEA and CA15-3 and the other variables, except for CA 15-3 vs. tumor size, which showed a mild (R=0.57) linear relationship. Tumor size, ER rate, and the number of positive nodes were significantly (p<0.01) different between patients with CA 15-3 values normal and above the cut-off. Comparing the subgroup of patients with CA 15-3 above the cut-off and CEA within normal values (Group 1) versus patients with CA 15-3 within normal values and CEA above the cut-off (Group 2), a significant difference was found in the tumor size (Group 1: 28.3 ± 9 mm; Group 2: 17.9 ± 7.5 mm; p<0.0001) and in the number of positive nodes (Group 1: 2.2 ± 3.3; Group 2: 0.5 ± 1.5; p<0.01). Finally, CA 15-3, but not CEA, showed a significant correlation with the tumor grading (p<0.0001). Conclusion: In patients with BC, STM correlate exclusively with the size of the tumor. Both have low sensitivity and no significant relationship with other prognostic factors. Thus, preoperative serum tumor markers measurements are of little value, especially in patients with early-stage BC, and are not useful in the therapeutic decision-making of patients with BC.