Tissue and plasma carcinoembryonic antigen in early breast cancer. A prognostic factor.

A prospective study of plasma and tissue carcinoembryonic antigen (P-CEA and T-CEA) levels in 63 patients with early (Stage I and II) breast cancer was undertaken to determine if the presence of CEA in tissue and/or plasma at the time of primary surgery can be used as a prognostic factor. Thirty-two Stage I and 31 Stage II patients were evaluable with a median follow-up time of 26 months: 29/63 were T-CEA and/or P-CEA positive while 34/63 were T-CEA and P-CEA negative; 9/63 were both T-CEA and P-CEA positive; 13/63 were P-CEA positive alone, while 25/63 were T-CEA positive alone; 5/29 T-CEA and/or P-CEA positive showed disease progression with a mean DFI of 11.8 months, compared with 0/34 T-CEA and P-CEA negative patients (P less than 0.02); 2/9 T-CEA and P-CEA positive compared with 0/34 negative patients progressed (P less than 0.01). There was a significant difference (P less than 0.05) between P-CEA positive (3/13) patients with recurrence and P-CEA negative (2/50). When T-CEA positive patients (4/25) were compared with T-CEA negative (1/38), the difference approaches significance. When the recurrences were analyzed with respect to CEA, estrogen receptor (ER) and nodal status, only in the CEA + versus CEA - group was there a significant difference. The early data show that patients with positive T-CEA and/or P-CEA have a higher recurrence rate with probable poor prognosis. Prognosis correlates better with CEA status than with ER or nodal status.