Elevated preoperative serum cancer antigen 15.3 levels are associated with reduced disease-free survival: a single-institution experience

Figures & data

Table 1 Patient characteristics

Variables	N (%)
Age	Mean 47.0 years (range 23–76), SD ± 10.3
Age-groups (years)
<25	2 (1.9%)
25–35	21 (18.7%)
36–45	49 (43.7%)
>45	40 (35.7%)
Menopausal status
Premenopausal	93 (83%)
Postmenopausal	19 (17%)
Comorbidities
DM	9 (8.0%)
HTN	14 (12.5%)
HL	2 (1.8%)
DM + HTN	6 (5.4%)
HL + DM + HTN	9 (8.0%)
Laterality
Unilateral	108 (96.4%)
Bilateral	4 (3.6%)
Side
Right	22 (20.4%)
Left	90 (79.6%)
T stage
T1	28 (25.0%)
T2	38 (34.0%)
T3	33 (29.5%)
T4	13 (11.5%)
N stage
N0	6 (5.4%)
N1	19 (17.0%)
N2	40 (35.6%)
N3	47 (42.0%)
Histological type
IDC	95 (84.8%)
ILC	6 (5.4%)
IDC + ILC	6 (5.4%)
Others	5 (4.4%)
LVSI
Positive	42 (37.5%)
Negative	70 (62.5%)
Receptor status
Luminal A	34 (30.4%)
Luminal B	31 (27.7%)
Basal	11 (9.8%)
HER2/neu	35 (32.1%)
Type of surgery
BCS	31 (28.7%)
MRM	81 (71.3%)
Chemotherapy
Yes	104 (92.7%)
No	8 (7.3%)
Radiation therapy
Yes	89 (79.5%)
No	23 (20.5%)
Hormonal therapy
Yes	66 (59.0%)
No	46 (41.0%)

Abbreviations: SD, standard deviation; DM, diabetes mellitus; HTN, hypertension; HL, hyperlipidemia; IDC, infiltrating ductal carcinoma; ILC, invasive lobular carcinoma; LVSI, lymphovascular space invasion; BCS, breast-conservation surgery; MRM, modified radical mastectomy; HER2, human epidermal growth factor receptor 2.

Figure 1 Correlation between preoperative serum cancer antigen (CA) 15.3 levels and postoperative primary tumor (T) stage.

Figure 2 Correlation between preoperative serum cancer antigen (CA) 15.3 levels and postoperative axillary nodal (N) status.

Table 2 Clinicopathological characteristics according to serum cancer antigen (CA) 15.3 groups

Variables	CA 15.3 <35 (n = 16)	CA 15.3 36–100 (n = 30)	CA 15.3 >100 (n = 66)	P-value
Age (years)
<45	7 (43.6%)	19 (63.4%)	46 (69.7%)	0.002
>45	9 (56.4%)	11 (36.6%)	20 (30.3%)
Menopausal status
Premenopausal	12 (75%)	23 (76.7%)	58 (87.9%)	0.003
Postmenopausal	4 (25%)	7 (23.3%)	8 (12.1%)
Tumor size
T1	7 (43.6%)	8 (26.7%)	13 (19.7%)	0.001
T2	7 (43.6%)	9 (30.0%)	22 (33.3%)
≥T3	2 (12.8%)	13 (43.3%)	31 (47.0%)
Nodal status
N0	6 (37.5%)	–	–	0.001
N1	4 (25.0%)	7 (23.3%)	8 (12.1%)
N2	6 (37.5%)	10 (33.4%)	24 (36.4%)
N3	–	13 (43.3%)	34 (51.5%)
TNM staging
I	6 (37.5%)	8 (26.7%)	8 (12.1%)	0.001
II	8 (50.0%)	9 (30.0%)	24 (36.4%)
III	2 (12.8%)	13 (43.3%)	34 (51.5%)
Grade
1	8 (50.0%)	7 (23.3%)	6 (9.1%)	0.02
2	7 (43.6%)	12 (40.0%)	28 (42.4%)
3	1 (6.4%)	11 (36.7%)	32 (48.5%)
LVSI
Yes	10 (62.5%)	12 (40.0%)	20 (30.3%)	0.1
No	6 (37.5%)	18 (60.0%)	46 (69.7%)
Receptor status
Luminal A	7 (43.6%)	11 (36.7%)	17 (25.8%)	0.0001
Luminal B	7 (43.6%)	9 (30.0%)	15 (22.7%)
Basal	–	1 (3.3%)	10 (15.1%)
HER2/neu	2 (12.8%)	9 (30.0%)	24 (36.4%)

Abbreviations: LVSI, lymphovascular space invasion; TNM, TNM Classification of Malignant Tumours; HER2, human epidermal growth factor receptor 2.

Figure 3 Disease-free survival according to cancer antigen (CA) 15.3-level groups.

Table 3 Cox regression (multivariate) analysis of prognostic factors for locoregional recurrence in breast cancer

Variables	Hazard ratio	Confidence interval	P-value
Age, years, <45 vs >45	2.7	2.2–3.1	0.02
Premenopausal vs postmenopausal	2.4	1.9–2.9	0.03
Luminal A vs luminal B	1.2	0.9–1.3	0.05
Luminal A vs other subtypes	1.1	0.8–1.2	0.4
<T3 vs T4	2.2	1.7–3.2	0.01
N1 vs N2	2.8	2.1–3.9	0.001
<G3 vs >G3	1.1	0.8–1.2	0.5
LVSI^+ vs LVSI^−	1.7	1.2–2.3	0.02
Adjuvant RT vs no RT	3.8	2.7–4.2	0.001
Adjuvant CT vs no CT	1.1	0.7–1.2	0.5
Adjuvant HT vs no HT	1.1	0.7–1.2	0.5

Abbreviations: LVSI, lymphovascular space invasion; RT, radiation therapy; CT, chemotherapy; HT, hormonal therapy; vs, versus.

Table 4 Cox regression (multivariate) analysis of prognostic factors for distant metastasis in breast cancer

Variables	Hazard ratio	Confidence interval	P-value
Age, years, <45 vs >45	2.6	2.1–3.0	0.02
Premenopausal vs postmenopausal	1.4	1.2–1.9	0.04
Luminal A vs luminal B	5.2	3.7–7.3	0.0001
Luminal A vs other subtypes	4.7	3.6–7.2	0.0001
<T3 vs T4	2.0	1.5–2.5	0.01
N1 vs N2	3.9	2.6–4.2	0.001
<G3 vs >G3	1.1	0.8–1.2	0.5
LVSI^+ vs LVSI^−	3.8	2.5–4.1	0.001
Adjuvant RT vs no RT	1.1	0.8–1.2	0.5
Adjuvant CT vs no CT	1.2	1.0–1.3	0.3
Adjuvant HT vs no HT	5.2	4.7–8.2	0.0001
Age, years, <45 vs >45	3.1	2.6–5.2	0.001

Abbreviations: LVSI, lymphovascular space invasion; RT, radiation therapy; CT, chemotherapy; HT, hormonal therapy; vs, versus.

Table 5 Cox regression (multivariate) analysis of prognostic factors for disease-free survival in breast cancer

Variables	Hazard ratio	Confidence interval	P-value
Age, years, <45 vs >45	2.5	2.0–2.9	0.02
Premenopausal vs postmenopausal	1.4	1.2–1.9	0.04
Luminal A vs luminal B	4.3	3.6–6.2	0.001
Luminal A vs other subtypes	5.7	4.5–8.2	0.0001
<T3 vs T4	2.0	1.5–2.5	0.01
N1 vs N2	2.9	2.5–3.5	0.002
<G3 vs >G3	1.1	0.8–1.2	0.5
LVSI^+ vs LVSI^−	1.1	0.8–1.2	0.5
Adjuvant RT vs no RT	2.7	2.4–2.9	0.002
Adjuvant CT vs no CT	1.1	0.9–1.2	0.3
Adjuvant HT vs no HT	3.5	3.0–5.2	0.0001
Age, years, <45 vs >45	2.1	1.8–3.3	0.002

Abbreviations: LVSI, lymphovascular space invasion; RT, radiation therapy; CT, chemotherapy; HT, hormonal therapy; vs, versus.