For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
14
views
25
references
 Top references
cited by
7
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      85
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Independent prognostic impact of preoperative serum carcinoembryonic antigen and cancer antigen 15-3 levels for early breast cancer subtypes

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Although the prognosis for operable breast cancers is reportedly worse if serum carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) levels are above normal, the usefulness of this prognosis is limited due to the low sensitivity and specificity; in addition, the optimal cutoff levels remain unknown.

          Methods

          A total of 1076 patients who were operated for breast cancers (test set = 608, validation set = 468) without evidence of metastasis were recruited, and their baseline and postoperative serum CEA and CA15-3 levels were analyzed. The optimal cutoff values of CEA and CA15-3 for disease-free survival (DFS) were 3.2 ng/mL and 13.3 U/mL, respectively, based on receiver operating characteristic curve and area under the curve analyses.

          Results

          The DFS of patients with high CEA levels (CEA-high: n = 191, 5-year DFS 70.6%) was significantly worse ( p < 0.0001) than that of CEA-low patients ( n = 885, 5-year DFS 87.2%). There was a significant difference in DFS ( p < 0.0001) between CA15-3-high and CA15-3-low patients ( n = 314 and n = 762, respectively; 5-year DFS 71.8 vs. 89.3%). Significant associations between DFS and CA15-3 levels were observed irrespective of the subtypes. Multivariable analysis indicated that tumor size, lymph node metastasis, tumor grade, and CEA ( p = 0.0474) and CA15-3 ( p < 0.0001) levels were independent prognostic factors (hazard ratio [HR] 1.520, 95% confidence interval [CI] 1.005–2.245 for CEA; HR 2.088, 95% CI 1.457–2.901 for CA15-3).

          Conclusions

          These findings suggest that CEA and CA15-3 levels might be useful for predicting the prognosis of patients with operable early breast cancer irrespective of the subtype. Serum levels at baseline may reflect tumor characteristics for metastatic potential even when these levels are within the normal ranges.

          Electronic supplementary material

          The online version of this article (10.1186/s12957-018-1325-6) contains supplementary material, which is available to authorized users.

          Related collections

          Most cited references25

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2009

          Michael Gnant, A Goldhirsch, J. N. Ingle … (2009)
          The 11th St Gallen (Switzerland) expert consensus meeting on the primary treatment of early breast cancer in March 2009 maintained an emphasis on targeting adjuvant systemic therapies according to subgroups defined by predictive markers. Any positive level of estrogen receptor (ER) expression is considered sufficient to justify the use of endocrine adjuvant therapy in almost all patients. Overexpression or amplification of HER2 by standard criteria is an indication for anti-HER2 therapy for all but the very lowest risk invasive tumours. The corollary is that ER and HER2 must be reliably and accurately measured. Indications for cytotoxic adjuvant therapy were refined, acknowledging the role of risk factors with the caveat that risk per se is not a target. Proliferation markers, including those identified in multigene array analyses, were recognised as important in this regard. The threshold for indication of each systemic treatment modality thus depends on different criteria which have been separately listed to clarify the therapeutic decision-making algorithm.
          Article 0 comments Cited 297 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Progress and promise: highlights of the international expert consensus on the primary therapy of early breast cancer 2007.

            A Goldhirsch, W.C. Wood, R.D. Gelber … (2007)
            The 10th St Gallen (Switzerland) expert consensus meeting in March 2007 refined and extended a target-oriented approach to adjuvant systemic therapy of early breast cancer. Target definition is inextricably intertwined with the availability of target-specific therapeutic agents. Since 2005, the presence of HER2 on the cell surface has been used as an effective target for trastuzumab much as steroid hormone receptors are targets for endocrine therapies. An expert Panel reaffirmed the primary importance of determining endocrine responsiveness of the cancer as a first approach to selecting systemic therapy. Three categories were acknowledged: highly endocrine responsive, incompletely endocrine responsive and endocrine non-responsive. The Panel accepted HER2-positivity to assign trastuzumab, and noted that adjuvant trastuzumab has only been assessed together with chemotherapy. They largely endorsed previous definitions of risk categories. While recognizing the existence of several molecularly-based tools for risk stratification, the Panel preferred to recommend the use of high-quality standard histopathological assessment for both risk allocation and target identification. Chemotherapy, although largely lacking specific target information, is the only option in cases which are both endocrine receptor-negative and HER2-negative. Chemotherapy is conventionally given with or preceding trastuzumab for patients with HER2-positive disease, and may be used for patients with endocrine responsive disease in cases where the sufficiency of endocrine therapy alone is uncertain. Recommendations are provided not as specific therapy guidelines but rather as a general guidance emphasizing main principles for tailoring therapeutic choice.
            Article 0 comments Cited 188 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Meeting highlights: international expert consensus on the primary therapy of early breast cancer 2005.

              A Goldhirsch, J.H. Glick, R.D. Gelber … (2005)
              The ninth St Gallen (Switzerland) expert consensus meeting in January 2005 made a fundamental change in the algorithm for selection of adjuvant systemic therapy for early breast cancer. Rather than the earlier approach commencing with risk assessment, the Panel affirmed that the first consideration was endocrine responsiveness. Three categories were acknowledged: endocrine responsive, endocrine non-responsive and tumors of uncertain endocrine responsiveness. The three categories were further divided according to menopausal status. Only then did the Panel divide patients into low-, intermediate- and high-risk categories. It agreed that axillary lymph node involvement did not automatically define high risk. Intermediate risk included both node-negative disease (if some features of the primary tumor indicated elevated risk) and patients with one to three involved lymph nodes without additional high-risk features such as HER 2/neu gene overexpression. The Panel recommended that patients be offered chemotherapy for endocrine non-responsive disease; endocrine therapy as the primary therapy for endocrine responsive disease, adding chemotherapy for some intermediate- and all high-risk groups in this category; and both chemotherapy and endocrine therapy for all patients in the uncertain endocrine response category except those in the low-risk group.
              Article 0 comments Cited 164 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Yasuo Miyoshi:
                ORCID: http://orcid.org/0000-0001-8535-4008
                +81-798-45-6374 , ymiyoshi@hyo-med.ac.jp
                Journal
                Journal ID (nlm-ta): World J Surg Oncol
                Journal ID (iso-abbrev): World J Surg Oncol
                Title: World Journal of Surgical Oncology
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1477-7819
                Publication date (Electronic): 12 February 2018
                Publication date PMC-release: 12 February 2018
                Publication date Collection: 2018
                Volume: 16
                Electronic Location Identifier: 26
                Affiliations
                [1 ]ISNI 0000 0000 9142 153X, GRID grid.272264.7, Department of Surgery, Division of Breast and Endocrine Surgery, , Hyogo College of Medicine, ; Mukogawa-cho 1-1, Nishinomiya City, Hyogo 663-8501 Japan
                [2 ]Department of Breast Surgery, Yao Municipal Hospital, Ryuka-cho 1-3-1, Yao City, Osaka 581-0069 Japan
                [3 ]Department of Surgery, Kobe Adventist Hospital, Arinodai,Kita-ku 8-4-1, Kobe, Hyogo 651-1312 Japan
                [4 ]Masai Breast Clinic, Funado-cho 2-1-205, Ashiya, Hyogo 659-0093 Japan
                [5 ]ISNI 0000 0004 0639 8670, GRID grid.412181.f, Department of Medical Informatics, , Niigata University Medical & Dental Hospital, ; Chuo-ku, Niigata Japan
                Author information
                http://orcid.org/0000-0001-8535-4008
                Article
                Publisher ID: 1325
                DOI: 10.1186/s12957-018-1325-6
                PMC ID: 5809836
                PubMed ID: 29433529
                SO-VID: b842698e-874e-40bb-b166-50afd14722db
                Copyright © © The Author(s). 2018
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 17 June 2017
                Date accepted : 30 January 2018
                Funding
                Funded by: Grant from Hyogo College of Medicine
                Award ID: No number was provided
                Award Recipient :
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © The Author(s) 2018

                ScienceOpen disciplines: Surgery
                Keywords: breast cancer,tumor marker,cea,ca15-3,prognosis
                Data availability:
                ScienceOpen disciplines: Surgery
                Keywords: breast cancer, tumor marker, cea, ca15-3, prognosis

                Comments

                Comment on this article

                scite_

                Similar content85

                See all similar

                Cited by7

                See all cited by

                Most referenced authors383

                See all reference authors