Abstract
Background
CA15-3 is the most commonly used tumor marker in breast cancer. Its prognostic role has been described in the metastatic setting, but the role of pre-surgical CA15-3 in the assessment of patients with breast cancer without metastasis has not been substantiated yet.
Methodology
From February 2014 for a 2-year period, this prospective study included all patients who were diagnosed with primary breast cancer and underwent surgery at a tertiary care hospital. The serum level of CA15-3 was assessed on a pre-surgical blood sample and later at the 3-, 6-, 9-, and 12-month follow-up by enzyme-linked immunosorbent assay. Disease-free survival (DFS) was analyzed with a Kaplan–Meier model and log-rank test.
Results
We enrolled 195 patients (mean age ± SD 57.84 years ±13.819, range, 28–95) with breast cancer. The prevalence of elevated (≥30 U/mL) pre-surgical CA15-3 was 35.9%, and it reduced to 14.3% at 3 months after mastectomy. Pre-surgical CA15-3 had a significant association only with the size of the tumor (p=0.047). Patients who did not have elevated pre-surgical CA15-3 (≥30 U/mL) had the best short-term DFS, and it was worst when the pre-surgical CA15-3 was >100 U/mL (p=0.041).
Conclusion
Elevated pre-surgical CA15-3 is a predictor of poor short-term DFS of patients with breast cancer without distant metastasis.
Acknowledgments
This work was supported by the Ministry of Science, Technology and Research, Sri Lanka (grant no MTR/TRD/AGR/3/1/9, Indo-Sri Lanka Joint Research Program 2012).
The authors acknowledge Dr Thusharie Liyanage, Mrs. GGDD Gunawardhane, and the staff of the Department of Pathology, Faculty of Medicine, University of Ruhuna for the support extended; the staff of the Oncology Unit, Teaching Hospital Karapitiya, Galle, Sri Lanka, for permitting the retrieval of follow-up details; and the staff of all general and onco-surgical units of the Teaching Hospital Karapitiya, Sri Lanka, for the support extended in enrolling patients to the study.
Disclosure
SNG, NL, and DA received a monthly stipend from the funding agency in the form of Research Assistant’s allowances. The authors report no other conflicts of interest in this work.