Relationship between Preoperative Serum Markers CA 15-3 and CEA and Relapse of the Disease in Elderly (> 65 years) Women with Breast Cancer

This study investigated whether preoperative carcinoma-associated antigen (CA) 15-3 and carcinoembryonic antigen (CEA) serum levels are predictive markers of reduced diseas-free (DF) survival in women with breast cancer (BC) who have undergone curative surgery A series of 363 consecutive postmenopausal women (median age 63 years, range 47-89 years) with pT1-2, N0-1 and M0 BC who underwent curative surgery and were followed-up for at least 36 months after lumpectomy or mastectomy were reviewed retrospectively. Two groups of patients were considered: Group 1 (age 47-64 years), 203 (55.9%) patients; Group 2 (age >64 years), 160 (44.1%) patients. None of the parameters (age, size of the tumour, CA 15-3 and CEA baseline serum levels, ER and PgR rate, MIB-1 labelling index) differed between the groups. During follow-up (36-60 months) 62 (17.1%) patients developed relapse (DR) of the disease (41 and 21 among Groups 1 and 2, respectively), while 301 (82.9%) were DF. The differences were as follows (DF vs. DR): Group 1: CA 15-3 (25.0±11.4 vs. 31.4±14.6 U/l; p=0.003) and CEA serum levels (5.7±4.8 vs. 7.4±6.4 ng/ml; p=0.048). Group 2: CA 15-3 (27.9±13.2 vs. 20.4±6.5 U/l; p=0.012) and CEA serum levels (6.6±5.2 vs. 3.7±2.5 ng/ml; p=0.013). Surprisingly, in the subgroup of patients aged >65 years who developed relapse, both CA 15-3 and CEA baseline serum levels were lower than in the subgroup of DF patients. In conclusion, although serum tumor markers levels may be useful during follow-up, their baseline levels are not useful in predicting relapse in elderly patients with BC.