J Cancer 2016; 7(1):37-41. doi:10.7150/jca.13090

Research Paper

Use of CEA and CA15-3 to Predict Axillary Lymph Node Metastasis in Patients with Breast Cancer

San-Gang Wu1*, Zhen-Yu He2*, Hong-Yue Ren3*, Li-Chao Yang4, Jia-Yuan Sun2, Feng-Yan Li2, Ling Guo5✉, Huan-Xin Lin2✉

1. Xiamen Cancer Center, Department of Radiation Oncology, the First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China;
2. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Radiation Oncology, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China;
3. Biobank, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China;
4. Department of Basic Medical Science, Medical College, Xiamen University, Xiamen, People's Republic of China;
5. Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Department of Nasopharyngeal Carcinoma, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China.
* Equally contributors

Abstract

Purpose: The clinical significance of preoperative serum levels of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) in breast cancer is controversial. The purpose of this study was to assess the clinical value of preoperative serum levels of CEA and CA 15-3 on the risk of axillary lymph node metastasis (ALNM) in patients with breast cancer.

Methods: This retrospective study analyzed 1148 breast cancer patients whose preoperative CEA and CA 15-3 levels were measured. The association of these tumor markers and clinicopathologic parameters with ALNM was determined by univariate and multivariate analysis.

Results: A median of 15 lymph nodes were removed. Seven hundred seventy-eight (67.8%) patients had node-negative disease and 370 (32.2%) had ALNM. Univariate analysis showed that tumor location (P = 0.024), stage (P = 0.001), grade (P < 0.001), lymphovascular invasion (LVI) (P < 0.001), CEA level (P < 0.001), CA15-3 level (P < 0.001), and breast cancer subtype (BCS) (P < 0.001) were significantly associated with ALNM. ALNM was present in 4.5% of patients with normal CEA and 11.6% of patients with elevated CEA. ALNM was present in 8.0% of patients with normal CA15-3 and 17.0% of patients with high CA15-3. Multivariate logistic regression analysis showed that tumor location, stage, grade, LVI, CEA, CA15-3, and BCS were significantly and independently associated with ALNM (P < 0.05 for all).

Conclusion: The probability of ALNM was greater in patients with elevated preoperative serum levels of CEA and CA15-3. CEA and CA15-3 appear to be independent predictors of ALNM in breast cancer.

Keywords: Breast cancer, axillary lymph node metastases, CEA, CA15-3.

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How to cite this article:
Wu SG, He ZY, Ren HY, Yang LC, Sun JY, Li FY, Guo L, Lin HX. Use of CEA and CA15-3 to Predict Axillary Lymph Node Metastasis in Patients with Breast Cancer. J Cancer 2016; 7(1):37-41. doi:10.7150/jca.13090. Available from http://www.jcancer.org/v07p0037.htm