Use of CA15-3, CEA and prolactin for the primary diagnosis of breast cancer and correlation with the prognostic factors at the time of initial diagnosis

The main goals of the clinical use of tumor markers are to evaluate the ade quacy of the treatment, monitor recurrence and follow up response to the tr eatment applied. For this purpose a baseline level for the commonly used tu mor marker must be known at the time of initial diagnosis, before any thera py, in order to compare with the tumor marker levels which will be obtained after the treatment and during the clinical follow-up. The aim of this stu dy was to investigate the correlation, if there is any, of the baseline lev els of CA 15-3, CEA and prolactin (PRL) in patients with breast cancer with the most commonly used prognostic factors, i) the presence of distant meta stasis, ii) the presence of axillary lymphatic invasion, iii) the number of invaded axillary lymph nodes, iv) tumor size and v) stage of the disease, fur breast cancer. Baseline serum CA15-3, CEA and PRL levels of 172 patient s with breast masses were determined prior to biopsy. The sensitivity and s pecificity of baseline CA15-3, CEA and PRL were; 23.2% and 95.3%, 17.4% and 83.7%, 5.8% and 97.6%, respectively. At least one of the three tumor marke rs was high in 36% (31/86) of the breast cancer patients. Baseline CA 15-3 levels were frequently higher than CE;A in patients with bone metastasis (6 0% vs. 20%) and axillary lymphatic invasion (31.8% vs. 25%), and showed a b etter correlation with the stage of disease. Baseline tumor marker levels s howed no statistically significant correlation with either the number of in vaded axillary lymph nodes or tumor size. In conclusion, sensitivities and negative predictive values for baseline CA 15-3, CEA and PRL were not satis factory for primary diagnosis of breast cancer. Correlation of baseline CA 15-3 was found superior to CEA and PRL in terms of stage of disease, presen ce of axillary invasion and distant metastasis.