Omer Riaz, Ahsan Mahmood, Zeeshan Ahmed Alvi, Saffia Gul, Shahid Rasul, Naeem Haider.
Frequency of Increase in Serum Tumor Marker Carcinoembbryonic Antigen (CEA) Levels in Primary Breast Cancer (PBC) patients at the Time of Diagnosis.
Pak Armed Forces Med J Jan ;67(2):322-6.

Objective: To determine the frequency of increase in serum tumor marker CEA levels in PBC patients at the time of diagnosis. Study Design: Cross sectional study. Place and Duration of Study: Oncology Department of Combined Military Hospital (CMH) Rawalpindi, from January 2014 to November 2014. Material and Methods: Sixty three female patients with histopathologically confirmed carcinoma of breast and age range from 20 to 70 years from Oncology outpatient department (OPD)/indoor patient department at CMH Rawalpindi, were selected. All patients were staged by clinical and radiological work-up that included physical examination, all base line investigations, serum biomarkers, chest radiograph, ultrasound abdomen and pelvis, bone scan, computed tomography (CT) scan/magnetic resonance imaging (MRI) of the chest (optional). Patients serum carcino-embryonic antigen (CEA) levels were carried out only by blood sampling using chemiluminescent immunoassay with immulite 2000 CEA. Data analysis were done with the help of the Statistical Package for the Social Sciences (SPSS) version 19 software. Cut-off values of serum CEA levels >2.5 ng/ml were taken as elevated. Results: Sixty three female breast cancer patients with histopathologically confirmed carcinoma of breast revealed elevated serum CEA levels in three stages of the disease. The median age was 47 years (range, 20-70 years). Fifteen (23.8%) patients had family history of the breast cancer. Invasive ductal carcinoma (IDCA) was the commonest histology with 60 (95.23%) patients. Most of the patients had advanced stage of the disease. Node positive cases were 53 (84.1%). The frequency of abnormal CEA levels were varying from stage II to stage IV. Elevated serum CEA levels were noted in 4 (28.6%) of stage II, 19 (76%) of stage III and 17 (77.3%) patients of stage IV, respectively. Overall percentage increase in levels of serum CEA from stage I through IV were 0%, 6.34%, 30.2%, 26% respectively. The sensitivity of serum CEA in our primary breast cancer (PBC) patients was 63.5%. Conclusion: It is concluded that serum CEA had significant sensitivity in detecting breast cancer in our population. Elevated serum CEA levels were seen in various stages of our PBC patients.

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