SERIAL CARCINOEMBRYONIC ANTIGEN (CEA) DETERMINATIONS IN THE MANAGEMENT OF METASTATIC BREAST-CANCER

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  • 1 January 1980
    • journal article
    • research article
    • Vol. 1  (2) , 123-135
Abstract
Serum CEA [carcinoembryonic antigen] levels were determined in 2095 patients following mastectomy for breast cancer by means of a double antibody 125I-CEA-radioimmunoassay. A total of 91% of 1462 patients free of metastases had normal levels .ltoreq. 3 ng/ml (98% .ltoreq. 5 ng/ml); 54% of 633 patients with overt metastases had raised values > 3 ng/ml (43% > 5 ng/ml). The incidence of pathological levels was dependent on tumor burden and metastatic location rising from solitary lymph node disease (6% > 5 ng/ml) to skin, lung, bone, liver and multiple organ involvement (60%). CEA levels correlated weakly with total alkaline phosphatase and .gamma.-GT activities, but not with ESR [erythrocyte sedimentation rate] or bilirubin levels. Of 531 patients followed after surgery and who had 3-18 serial determinations in 3-51 mo., 46% without metastases had normal CEA levels as did 41% of 285 patients with metastases. Of the remaining 168 patients with elevated CEA levels, most showed a correlation between rising levels and disease progression, decreasing levels with remission and persistence of fluctuating levels with stationary disease. The CEA test is recommended as a valuable adjunct to monitor the clinical response to chemo/hormo/radiotherapy in metastatic breast cancer.