Abstract
Breast cancer is the most common malignancy in women, options for treatment of breast cancers are complex and varied, there is a need for biological prognostic indicators that would, alone or in combination with others, be sufficient to predict disease recurrence and hence, the basis for supplemental treatment after local therapy.
The aim of this study was to determine prognostic significance of serum Her2/neu, BCL2, CA 15-3 and CEA during the follow-up of the patients with breast cancer, also, to investigate the association between these biomarkers and clinicopathological parameters and patient outcomes in breast cancer.
Patients and methods: Eighty nine patients with breast cancer stage I and II are enrolled in our study. Their age ranged from 35–59 years. Patients underwent radical mastectomy or breast-conserving surgery with axillary lymph node dissection. After the surgical treatment they had supplementary therapy. The size of the tumor was < 2 cm in 35 patients and > 2 cm in 54 patients. Their histological type was invasive duct carcinoma, 49 patients had lymph node positive and 40 had negative lymph node. Nine patients had recurrence of the disease during the 18 months of follow up. BCL2, Her2/neu, CEA and CA15-3 in sera had been monitored by ELISA before and after operation, every 6 months and at the time of diagnosis of first recurrence for 18 months.
Results: Preoperative serum levels of Her2/neu, BCL2, CA15-3 and CEA were significantly higher compared with the levels of the control group, these markers dropped significantly after operation. Univariate analysis of parameters associated with relapse showed that the clinicopathological factors (histologic grade, tumor stage and lymph nodes) and serum markers (HER2/neu, BCL2, CA15-3 and CEA) were significantly associated with recurrence of disease. Multivariate analysis of investigated parameters revealed that tumor stage, lymph nodes and serum tumor markers were significant variables predicting recurrence of tumor.
Conclusion: Serum Her2/neu, BCL2, CA15-3 and CEA in breast cancer patients were useful markers for predicting aggressive behaviorof tumor and elevated serum levels are associated with breast cancer relapse. Our relatively small study population limits the predictive power of the panels presented here, but the benefits of a serum biomarker and multimarker approach are clearly illustrated and further studies utilizing larger clinical cohorts are well warranted.