A NOVEL METHOD FOR MONITORING HIGH-RISK BREAST-CANCER WITH TUMOR-MARKERS - CA-15.3 COMPARED TO CEA AND TPA

Background: An early and reliable diagnosis of metastatic spread has i ncreased interest in serum tumor markers. This study investigated the ability of CA 15.3, CEA, and TPA to identify, predict, and exclude met astases in bone/viscera during adjuvant treatment and follow-up of hig h-risk breast cancer. Methods: Ninety females with high-risk breast ca ncer were included in the study. Response evaluation was based upon cl inical examination, x-rays or histology and elaborated marker criteria . Results: During the marker monitoring period, metastases in four pat ients were confined to skin or lymph nodes, 21 developed metastases to bone/viscera, and 65 females had no evidence of metastases. CA 15.3, CEA, and TPA correctly classified 48%, 10%, and 19% of the patients wi th metastases in bone/viscera, and 100%, 94%, and 98% without. Followi ng CA 15.3, CEA, and TPA recurrence, 100%, 33%, and 60% of the patient s developed metastases in bone/viscera. Metastases in bone/viscera wer e excluded in 86%, 76%, and 79% of patients without CA 15.3, CEA, and TPA recurrence. Conclusion: Only CA 15.3 gave reliable information abo ut recurrence. Metastases in bone/viscera were identified in 10 of the 21 patients with CA 15.3. There was no false-positive CA 15.3 informa tion on the 65 patients without clinical recurrence. The PVneg (86%) i ndicated that when CA 15.3 did not signal recurrence, metastases to bo ne/viscera were not likely.