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

Sang eun Nam, Woosung Lim, Joon Jeong, Seeyoun Lee, Jungeun Choi, Heung Kyu Park, Yong Sik Jung, Seung Pil Jung, Soo Youn Bae

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)669-678
Number of pages10
JournalBreast Cancer Research and Treatment
Volume177
Issue number3
DOIs
Publication statusPublished - 2019 Oct 1

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Carcinoembryonic Antigen
Differentiation Antigens
Neoplasm Antigens
Tumor Biomarkers
Registries
Breast Neoplasms
Antigens
Neoplasms
Triple Negative Breast Neoplasms
Survival
Databases

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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Nam, Sang eun ; Lim, Woosung ; Jeong, Joon ; Lee, Seeyoun ; Choi, Jungeun ; Park, Heung Kyu ; Jung, Yong Sik ; Jung, Seung Pil ; Bae, Soo Youn. / The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients : data from the Korean Breast Cancer Society Registry. In: Breast Cancer Research and Treatment. 2019 ; Vol. 177, No. 3. pp. 669-678.
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title = "The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients: data from the Korean Breast Cancer Society Registry",
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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The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients : data from the Korean Breast Cancer Society Registry. / Nam, Sang eun; Lim, Woosung; Jeong, Joon; Lee, Seeyoun; Choi, Jungeun; Park, Heung Kyu; Jung, Yong Sik; Jung, Seung Pil; Bae, Soo Youn.

In: Breast Cancer Research and Treatment, Vol. 177, No. 3, 01.10.2019, p. 669-678.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The prognostic significance of preoperative tumor marker (CEA, CA15-3) elevation in breast cancer patients

T2 - data from the Korean Breast Cancer Society Registry

AU - Nam, Sang eun

AU - Lim, Woosung

AU - Jeong, Joon

AU - Lee, Seeyoun

AU - Choi, Jungeun

AU - Park, Heung Kyu

AU - Jung, Yong Sik

AU - Jung, Seung Pil

AU - Bae, Soo Youn

PY - 2019/10/1

Y1 - 2019/10/1

N2 - 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.

AB - 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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