A PROSPECTIVE EVALUATION OF CA15-3 IN STAGE-I CARCINOMA OF THE BREAST

BACKGROUND: Carcinoma of the breast is characterized by a variable cou rse with prognosis dependent on disease stage at presentation. Paradox ically, some patients with early malignancy demonstrate disease progre ssion within a short time. The role of tumor markers in the management of carcinoma of the breast is controversial. While CA15-3 is the most widely used tumor marker in carcinoma of the breast, its role in the management of patients with early disease is controversial. STUDY DESI GN: Since 1986, all patients presenting to our unit with carcinoma of the breast have had serial CA15-3 levels measured. This study evaluate s the role of serial CA15-3 levels in the management of a consecutive series of 168 patients with Stage I disease at presentation. RESULTS: The mean preoperative CA15-3 levels at presentation were significantly elevated in patients with Stage I disease compared with patients with benign disease. Sixteen patients had either locoregional (five patien ts) or metastatic recurrence (11 patients). CA15-3 levels were not ele vated in patients with locoregional disease and were significantly ele vated in patients with bony metastases and gave a mean lead time of 6. 3 months over bone scintigraphy. CONCLUSIONS: Serial CA15-3 measuremen ts are an efficient and cost-effective method of monitoring disease pr ogression and have advantages over conventional investigations in pati ents with early carcinoma of the breast.