C-erbB-2 CEA and CA 15.3 serum levels in the early diagnosis of recurrencein breast cancer patients

C-erbB-2 CEA and CA 15.3 serial serum determinations were performed in 250 patients (follow-up: 1-4 years, mean 2.5 years) with primary breast cancer and no evidence of residual disease (NED) after radical treatment (radical mastectomy or simple mastectomy and radiotherapy). Ninety-five patients dev eloped metastases during follow-up. Results: Abnormal c-erbB-2, CEA and CA 15.3 serum levels (>20 U/ml, >10 ng/ml or >60 U/ml, respectively) prior to diagnosis were found in 28.4%, 31.6% and 46.3% of the 95 patients with recu rrence with a lead time of 4.2 +/- 2.4, 5.0 +/- 2.5 and 4.6 +/- 2.7 months, respectively. One of the tumor markers was the first sign of recurrence in 69.5% of the patients. Tumor marker specificity was 100% with levels lower than the cut-point in all 155 patients without recurrence. Tumor marker se nsitivity was clearly related to the site of recurrence with the lowest sen sitivity found in locoregional relapse and the highest in patients with liv er or bone metastases. C-erbB-2 sensitivity in early diagnosis was signific antly higher in patients with c-erbB-2 overexpression in tissue (10/12, 83. 3%) than in those without overexpression (1/34, 2.9%) (p = 0.0001). likewis e higher levels of both, c-erbB-2 and CA 15.3 at diagnosis of recurrence hi gher sensitivity in early diagnosis of relapse and a higher lead time were found in PgR+ patients (CA 15.3) or in PgR- patients (C-erbB-2) (p < 0.015) . In conclusion,tumor markers are useful tools for the early diagnosis of m etastases, being the first sign of recurrence in 69.5% of patients with rel apse (76.3% in patients with metastases).