The Role of Carcinoembryonic Antigen in the Postmastectomy Follow-Up of Primary Breast Cancer and in the Prognostic Evaluation of Disseminated Breast Cancer

Abstract

Serum levels of carcinoeinbryonic antigen (CEA) were evaluated in 145 patients with breast cancer. There were 107 patients with « indolent » disease: 8 had previous metastases in complete posttherapeutic remission and were CEA-negative; CEA became positive in 2 of 3 of these cases who subsequently relapsed. The other 99 patients were without clinical evidence of disease after mastectomy. Of these, 82 were disease-free and CEA-negative, 2 relapsed and simultaneously became CEA-positive, 4 had recurrences but remained CEA-negative, 4 became CEA-positive but without clinical signs of metastases, and 7 became CEA positive before the clinical-instrumental diagnosis of metastasis. CEA was positive in 23 of 38 patients (60.5 %) with « active » disease. Response to medical therapy occurred in 6.6 % of CEA-negative patients compared to 55.0 % of CEA-positive patients. Among CEA-positive patients, there was a similar percentage of response to medical therapy in patients with small (50.0 %) or large (56.5 %) tumor burden. A response to medical therapy was observed in all patients with a disease-free interval equal to or greater than 24 months and CEA-positive.