Serum tumor markers CEA and CA 15-3, hormone receptor rate and MIB-1 score and their relationship in elderly women with breast cancer

Background: Breast cancer (BC) is common in elderly (>64 years) women, but the relationship between serum tumor markers, proliferation markers, and estrogen- (ER) and progesterone (PgR) rate is unclear. The aim of this study was to analyze whether preoperative serum levels of CEA and CA 15-3 correlate with well-established prognostic variables (i.e. MIB-1, ER, PgR) in patients with BC, according to age. Materials and Methods: We evaluated a consecutive series of 349 women (median age 61 years, range 26-89 years) with pT1-2 BC who underwent curative surgery. Entry criteria for this retrospective study included no history of previous cancer, no evidence of multicentric BC or distant metastases, and no multifocal BC at final pathology. Patients were divided into two groups: Group A, 237 (60.2%) women <65 years (median age 51.7±8.7 years), and Group B, 157 (39.8%) women >64 years (median age 74.6±6.1 years; p<0.001). Overall, the following data were recorded: 1) greatest diameter (size) of the tumor=21.0±13.8 mm, 2) CEA=3.6±9.8 ng/mL, 3) CA 15-3=21.4±20.7 U/mL, 4) ER=58.5±34.4 %, 5) PgR=51.0±34.9 %, and 5) MIB-1=18.5±9.8 %. Results: Size of the tumor (19.9±13.5 vs. 22.7±14.1 mm; p=0.048), (ER (54.3±36.0 vs. 64.7±31.0 %; p=0.003), PgR (47.2±34.9 vs. 57.0±34.1 %; p=0.006), CEA (2.7±8.5 vs. 4.8±11.5 ng/mL; p=0.037), and CA 15-3 (19.0±14.3 vs. 24.9±27.4 U/mL; p=0.006) were higher in older patients, while the MIB-1 rate (20.3±19.4 vs. 15.8±16.3 %; p=0.017) was lower (Group A vs. B). As expected, a significant (p<0.05) relationship was found between size of the tumor and CA 15-3 (R=0.21 and 0.25), ER and PgR (R=0.74 and 0.70), and ER and MIB-1 (R=0.38 and 0.41) in Groups A and B, respectively. Moreover, there was a correlation (p<0.05) between MIB-1 and both PgR (R=35) and CA 15-3 (R=21) only in younger patients. No other correlations (p=NS) were found in each group. Conclusions: These data suggest that preoperative serum CEA and CA 15-3 measurement are not useful in the therapeutic decision-making in patients with BC. However, MIB-1 index, showing a significant inverse relationship with ER independent from age, should be considered an affective parameter for assessing tumor proliferation, especially in younger patients.