Serial determination of CEA and CA 15.3 in breast cancer follow-up: An assessment of their diagnostic accuracy for the detection of tumour recurrences |
| |
Authors: | Luigi Mariani Rosalba Miceli Silvia Michilin Massimo Gion |
| |
Affiliation: | 1. Unit of Medical Statistics and Biometry, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italyluigi.mariani@istitutotumori.mi.it;3. Unit of Medical Statistics and Biometry, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy;4. Associazione ABO per l’Applicazione delle Biotecnologie in Oncologia, Centro Regionale Indicatori Biochimici di Tumore, Consorzio Istituto Oncologico Veneto IRCCS, AULSS 12 – Venezia, Italy;5. Centro Regionale Indicatori Biochimici di Tumore, Consorzio Istituto Oncologico Veneto IRCCS, AULSS 12 – Venezia, Italy |
| |
Abstract: | We studied the diagnostic accuracy of carcinoembryonic antigen (CEA) and cancer antigen 15.3 (CA 15.3) in detecting breast cancer recurrence. Biomarker follow-up determinations, made over 900 patients, were related to local–regional or distant recurrence using statistical models for longitudinal data. The diagnostic accuracy was quantified in terms of sensitivity, specificity and Youden index. The biomarkers were poorly predictive of local–regional recurrence. As for distant recurrence, the best diagnostic accuracy was obtained considering the two biomarkers jointly and combining two positivity criteria: a value above the normal limit or a difference between two consecutive measurements greater than the critical difference for at least one biomarker. A third criterion, based on within-patient comparison between follow-up determinations and a baseline, failed to improve the above result. CEA and CA 15.3 might play a role in patient monitoring during follow-up for the search of distant recurrence. |
| |
Keywords: | Breast cancer CEA CA 15.3 sensitivity specificity decision criteria |
|
|