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Elevated pre-surgical CA15-3: does it predict the short-term disease-free survival of breast cancer patients without distant metastasis?

Authors Mudduwa LKB, Wijayaratne GB, Peiris HH, Gunasekera SN, Abeysiriwardhana D, Liyanage N

Received 17 January 2018

Accepted for publication 14 March 2018

Published 26 June 2018 Volume 2018:10 Pages 329—335

DOI https://doi.org/10.2147/IJWH.S162867

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 2

Editor who approved publication: Professor Elie Al-Chaer


Lakmini KB Mudduwa,1 Gaya B Wijayaratne,2 Harshini H Peiris,3 Shania N Gunasekera,1 Deepthika Abeysiriwardhana,1 Nimsha Liyanage1

1Department of Pathology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka; 2Department of Microbiology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka; 3Medical Laboratory Science Degree Program, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka

Background:
CA15-3 is the most commonly used tumor marker in breast cancer. Its prognostic role has been described in the metastatic setting, but the role of pre-surgical CA15-3 in the assessment of patients with breast cancer without metastasis has not been substantiated yet.
Methodology: From February 2014 for a 2-year period, this prospective study included all patients who were diagnosed with primary breast cancer and underwent surgery at a tertiary care hospital. The serum level of CA15-3 was assessed on a pre-surgical blood sample and later at the 3-, 6-, 9-, and 12-month follow-up by enzyme-linked immunosorbent assay. Disease-free survival (DFS) was analyzed with a Kaplan–Meier model and log-rank test.
Results: We enrolled 195 patients (mean age ± SD 57.84 years ±13.819, range, 28–95) with breast cancer. The prevalence of elevated (≥30 U/mL) pre-surgical CA15-3 was 35.9%, and it reduced to 14.3% at 3 months after mastectomy. Pre-surgical CA15-3 had a significant association only with the size of the tumor (p=0.047). Patients who did not have elevated pre-surgical CA15-3 (≥30 U/mL) had the best short-term DFS, and it was worst when the pre-surgical CA15-3 was >100 U/mL (p=0.041).
Conclusion: Elevated pre-surgical CA15-3 is a predictor of poor short-term DFS of patients with breast cancer without distant metastasis.

Keywords: breast cancer, pre-surgical CA15-3, short-term disease-free survival, prognosis

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