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

Several tumor markers have been proposed to indicate presence and future behavior of breast cancer (BC). However, their sensitivity is usually considered low, especially in patients with early-stage tumors. The aim of this study was to analyze whether a correlation exists between preoperative serum tumor markers CEA and CA 15-3, age of the patients, TNM staging, hormone receptor (ER, PgR) status, and MIBI proliferation index in patients who underwent curative surgery for primary BC. Patients and Methods: Data regarding a series of 255 consecutive women (median age 60 years, range 30-85) with pT1-2 (pT1a=9, 3.5%; pT1b=38, 14.9%; pT1c=l07, 42.0%, pT2=107, 39.6%) BC were reviewed, while patients with confirmed pT3-4 BC were excluded. The greatest diameter of the tumor measured by the pathologist (size) ranged from 3 and 48 mm (median 19 mm). There were 71 (27.8%) premenopausal and 184 (72.2%) postmenopausal women. Two groups of patients were considered according to the axillary lymph node status: Group A, 70 (27.5%) cases (pN1), and Group B, 185 (72.5%) cases (pN0). 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 MlBl index. Results: CEAand CA 15-3 serum levels were above the cut-off (10 ng/mL, and 30 U/L, respectively) in 44 (17.2%) and 75 (29.0%) patients (Group A: 22.9% and 47.0%, Group B: 15.1% and 23.0%, respectively; p=NS). Size (23.9±9.0 vs. 18.2±9.3 mm), ER rate (51.3±37.7 vs. 60.4±30.6), MlBl index (30.1+26.3 vs. 17.8±21.0), CEA (4.3±4.8 vs. 3.4±2.7 ng/mL) and CA 15-3 (26.8±16.3 vs. 18.2±15.1 U/L) serum levels were significantly different (p<0.05) in Groups A and B patients. Overall, a significant correlation between size of the tumor and both CEA (R=0.22, p=0.003) and CA 15-3 (R=0.57, p<0.0001) and between ER rate and Ml61 index (R=-0.59, p<0.0001) was found. there was no relationship between age of the patients, size (R=0.08, p=0.20), and ER (R=0.13, p=0.71). Among Group A patients, a significant correlation between number of involved nodes and both CEA (R=0.24, p=0.04) and CA 15-3 (R=0.31, p=0.007) serum levels was found, but there was no relationship (p=NS) with age, ER rate and MIB1 index. Conclusions: In patients with BC, serum markers CEA and CA 15- 3 correlate exclusively with the size of the tumor. On account of their low sensitivity and in lack of relationship with others prognostic factors, preoperative CEA and CA 15-3 serum levels measurements are of little value in patients undergoing curative surgery for primary BC.