How Useful Are Tumor Markers in Detecting Metastases with FDG-PET/CT during Breast Cancer Surveillance?
- 1 October 2020
- journal article
- research article
- Published by S. Karger AG in Oncology
- Vol. 98 (10), 714-718
- https://doi.org/10.1159/000507707
Abstract
Background:To assess the clinical usefulness of serum tumor markers for early detection of distant breast cancer recurrence using FDG-PET/CT.Methods:We retrospectively analyzed 561 consecutive patients who underwent surgery for invasive primary breast cancer and had increased tumor markers (CA 15-3 and CEA) after completion of locoregional therapy. FDG-PET/CT data were reviewed for all cases. CA 15-3 and CEA were evaluated both in a continuous and in a quartile (Q) distribution. The Wilcoxon rank-sum test and logistic regression models were used to evaluate the association between increased tumor marker values and the presence (and type) of distant metastases.Results:The median value of CA 15-3 was 35.0 U/mL (IQR, 29.5-43.0) in cases where no distant metastases were detected, and it was 58.9 U/mL (IQR, 40.0-108.0) in cases where metastases were detected (p< 0.001). The median value of CEA was 6.6 U/mL (IQR, 4.4-10.0) in cases of no metastases and 12.4 U/mL (IQR, 6.9-30.0) in cases of metastases (p< 0.001). Increased levels of both tumor markers (Q3 and Q4) were strongly associated with the presence of distant metastases. The association between CA 15-3 and bone/liver metastases was stronger compared with other types of metastases (pheterogeneity between odds ratios [ORs] = 0.03 for Q3 and <0.001 for Q4), while no relevant heterogeneity between ORs emerged for CEA.Conclusion:Increased tumor marker levels detected in asymptomatic breast cancer patients during adjuvant therapies and follow-up are significantly predictive of distant metastases identified on FDG-PET/CT.Keywords
This publication has 13 references indexed in Scilit:
- Ipsilateral Breast Tumor Reappearance and Contralateral Breast Cancer after Primary Breast Cancer Treatment: A Comprehensive Retrospective Study of 15,168 PatientsOncology, 2018
- Comparative diagnostic accuracy of 18F-FDG PET/CT for breast cancer recurrenceBreast Cancer: Targets and Therapy, 2017
- Role of 2-[18F] Fluoro-2-Deoxy-D-Glucose-Positron Emission Tomography/Computed Tomography in the Post-Therapy Surveillance of Breast CancerPLOS ONE, 2014
- Oligometastatic Breast Cancer: A Shift from Palliative to Potentially Curative Treatment?Breast Care, 2014
- Breast Cancer Follow-Up and Management After Primary Treatment: American Society of Clinical Oncology Clinical Practice Guideline UpdateJournal of Clinical Oncology, 2013
- Tumor Marker–Guided PET in Breast Cancer Patients—A Recipe for a Perfect WeddingClinical Nuclear Medicine, 2012
- The impact of FDG-PET/CT on the management of breast cancer patients with elevated tumor markers and negative or equivocal conventional imaging modalitiesNuclear Medicine Communications, 2011
- Breast cancer recurrence diagnosis suspected on tumor marker risingCancer, 2010
- Inconsistent Criteria Used in American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast CancerJournal of Clinical Oncology, 2008
- American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast CancerJournal of Clinical Oncology, 2007