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The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients: data from the Korean Breast Cancer Society Registry

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Abstract

Purpose

Tumor markers such as carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) are widely used for monitoring breast cancer. However, the prognostic efficacy of preoperative elevations of CEA and CA15-3 levels in breast cancer patients remains controversial.

Methods

We retrospectively analyzed the clinicopathological parameters of 149,238 patients in the Korean Breast Cancer Society Registry Database who underwent surgery between January 2000 and December 2015.

Results

The patients with elevated CA15-3/CEA levels had worse overall survival (OS) than the patients with normal CA15-3/CEA levels. For the luminal A subtype, the CA15-3- and CEA-elevated group had a hazard ratio (HR) of 2.14 (95% CI 1.01–4.55). The CA15-3-elevated group had an HR of 2.38 (95% CI 1.58–3.58) and the CEA-elevated group had an HR of 1.79 (95% CI 1.20–2.68) compared to the normal group. For the luminal B subtype, the CA15-3- and CEA-elevated group had an HR of 3.99 (95% CI 2.23–7.16), whereas the CA15-3-elevated group had an HR of 2.38 (95% CI 1.58–3.58) and the CEA-elevated group had an HR of 1.79 (95% CI 1.20–2.68). For the HER2 subtype, elevated CEA level was the only independent prognostic factor. However, for the triple-negative breast cancer (TNBC) subtype, elevated preoperative CEA and CA15-3 levels were not significant prognostic factors for OS.

Conclusion

Preoperative CEA and CA15-3 levels showed varying prognostic ability according to breast cancer subtype. Preoperative CA15-3 and CEA elevation are significant prognostic factors for luminal breast cancer, but they were not significant factors for TNBC.

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Acknowledgements

This article was supported by the Korean Breast Cancer Society.

Author information

Authors and Affiliations

  1. Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea

    Sang eun Nam

  2. Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea

    Woosung Lim

  3. Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Joon Jeong

  4. Department of Surgery, Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea

    Seeyoun Lee

  5. Division of Breast Surgical Oncology, Department of Surgery, Yeungnam University College of Medicine, Daegu, Republic of Korea

    Jungeun Choi

  6. Department of Surgery, Gachon University, Gil Medical Center, Incheon, Republic of Korea

    HeungKyu Park

  7. Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea

    Yong Sik Jung

  8. Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, Republic of Korea

    Seung Pil Jung & Soo Youn Bae

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  1. Sang eun Nam
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Correspondence to Soo Youn Bae.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Nam, S.e., Lim, W., Jeong, J. et al. The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients: data from the Korean Breast Cancer Society Registry. Breast Cancer Res Treat 177, 669–678 (2019). https://doi.org/10.1007/s10549-019-05357-y

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  • DOI: https://doi.org/10.1007/s10549-019-05357-y

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