High levels of serum CA15‐3 and residual invasive tumor size are associated with poor prognosis for breast cancer patients with non‐pathological complete response after neoadjuvant chemotherapy

Background and Objectives To identify surrogate markers for prognosis of breast cancer patients with non‐pathological complete response (non‐pCR) to neoadjuvant chemotherapy (NAC), our investigation focused on the serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA15‐3) as we...

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Bibliographic Details
Published in:Journal of surgical oncology 2018-07, Vol.118 (1), p.228-237
Main Authors: Fujimoto, Yukie, Higuchi, Tomoko, Nishimukai, Arisa, Miyagawa, Yoshimasa, Kira, Ayako, Ozawa, Hiromi, Bun, Ayako, Imamura, Michiko, Miyoshi, Yasuo
Format: Article
Language:English
Subjects:
Antigens
Breast cancer
CA15‐3
Cancer surgery
carcinoembryonic antigen (CEA)
Chemotherapy
Medical prognosis
prognosis
residual cancer
tumor marker
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Summary:Background and Objectives To identify surrogate markers for prognosis of breast cancer patients with non‐pathological complete response (non‐pCR) to neoadjuvant chemotherapy (NAC), our investigation focused on the serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA15‐3) as well as clinicopathological factors both before and after NAC. Methods A total of 185 breast cancer patients treated with NAC were recruited. Serum carcinoembryonic antigen and CA15‐3 were measured at baseline and at completion of NAC. Results Among the non‐pCR cancers (n = 142), the disease‐free survival (DFS) of patients with CA15‐3‐low at baseline (3‐year DFS: 0.908, n = 73) was significantly better than of those with CA15‐3‐high (3‐year DFS: 0.681, n = 69, P = .0134). Multivariable analysis demonstrated that baseline CA15‐3 levels (hazard ratio: 3.31, 95% confidence interval: 1.28‐10.23; P = .0122) and residual invasive size (hazard ratio: 4.47, 1.26‐28.39; P = .0171) were significant independent factors for DFS. The combination of these factors proved to be an accurate predictor for DFS regardless of breast cancer subtypes. Conclusions The combination of residual invasive size and serum CA15‐3 levels at baseline seems to be a significant and independent surrogate marker of poor outcome for patients with non‐pCR. These findings suggest that these markers may be useful for identifying patients with inferior prognosis and candidates for additional adjuvant treatments.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.25125