Abstract
Purpose
To examine the relationship between baseline elevated CA 15.3 (>30 kU/L) and the prevalence
of primary or secondary metastatic disease in breast cancer.
Methods
We performed a retrospective, single-center cohort study on patients with newly diagnosed
breast cancer and baseline CA 15.3> 30 kU/L, diagnosed between 2000-2015. Information
on tumor characteristics, pre-treatment CA 15.3, staging results, treatment approach,
disease recurrence and death were collected from individual medical files. For every
tumor subtype, the optimal cut-off value of CA 15.3 for determining primary metastatic
disease is determined.
Results
Eight hundred ninety-four patients with baseline CA15.3 > 30 kU/L were included of
which 38% were diagnosed with primary metastatic disease while 15% subsequently developed
secondary metastatic disease, with a median follow-up of 74 months. LuminalHER2 tumors
had the highest proportion of primary metastatic disease (48%), Triple Negative tumors
had the highest proportion of secondary metastatic disease (24%) (p=0.008). A higher
CA 15.3 value corresponds to higher risk of both primary and secondary metastatic
disease (p<0.001). For the determination of primary metastatic disease, optimal cut-off
values for CA 15.3 range between 44 kU/L (Triple Negative) and 59 kU/L (Luminal B).
Conclusion
In patients with newly diagnosed breast cancer and baseline elevated CA 15.3>30 kU/L,
38% presents with primary metastatic disease and 15% develops secondary metastatic
disease, with a median follow-up of 74 months. Our results can help clinicians to
identify patients at risk of primary or secondary metastatic disease via information
on tumor subtype and baseline CA 15.3.
Keywords
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Article Info
Publication History
Published online: April 29, 2022
Accepted:
April 20,
2022
Received in revised form:
March 28,
2022
Received:
January 5,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
