Role of Cancer antigen 15.3 in the pre-operative assessment of primary breast cancer

Abstract

BACKGROUND: Cancer antigen (CA) 15.3 is the most commonly used tumour marker in predicting recurrence of breast cancer. The role of pre-operative CA 15.3 in the assessment of breast cancer has not been substantiated yet. OBJECTIVE: To determine the role of CA 15.3 in the pre-operative assessment of breast cancer patients METHODS: All patients who were diagnosed of primary breast cancer and underwent surgery at a tertiary-care hospital from April 2014 to October 2015 were enrolled. Serum level of CA 15.3 was assessed on a pre-operative blood sample by ELISA and ≥30 U/ml was considered as the cut off as defined by the manufacturer’s literature. The association of CA 15.3 levels with the clinico-pathological parameters was analyzed with chi-square test. RESULTS: Of the 150 patients (mean age 56.83 [SD=13.39] years) enrolled, majority (85.6%) had grade 2/3 tumours with lymph node metastasis (58.2%) at the time of presentation. None had distant metastasis. Elevated pre-operative serum level of CA 15.3 was detected in 34% of patients who had more estrogen receptor negative(43.13%), progesterone receptor negative (50.98%) and triple negative(29.1%) tumours compared to those without elevated pre-operative CA 15.3 (p=0.017,0.036 and 0.001 respectively). There was no association with other clinico-pathological features. CONCLUSIONS: Pre-operative serum level of CA15.3 is elevated only in one third of breast cancer patients. Elevated pre-operative CA 15.3 has a prognostic value as it is elevated mostly in the hormone receptor negative and triple negative breast cancers predicting a poor prognosis.