Post-operative serum CEA predicts prognosis in HR-positive/HER2-negative early breast cancer

Background: The prognostic role of preoperative carcinoembryonic antigen (CEA) in breast cancer is recognized, but the impact of postoperative CEA levels on survival in early breast cancer is uncertain.

Research design and methods: We conducted a retrospective study of 921 non-metastatic breast cancer patients treated at anonymized. Patients were categorized as normal (CEA ≤3 µg/L) or elevated (CEA >3 µg/L).

Results: Elevated postoperative CEA levels were associated with shorter disease-free survival (DFS) (median, 174.6 vs. 239.8 months; hazard ratio (HR): 1.80; 95% confidence interval (CI): 1.27-2.56; p < 0.001) and overall survival (OS) (median, 174.6 vs. 261.1 months; HR:2.34; 95% CI: 1.59-3.45; p < 0.001). Elevated CEA was associated with shorter DFS (median, 174.6 months vs. not reached (NR); HR:2.30; 95% CI: 1.03-5.19; p = 0.043) and OS (NR vs. NR; HR: 2.81; 95% CI: 1.06-7.48; p = 0.039) in stage 1, shorter DFS (median, 239. 8 vs. 141.1 months; HR: 1.95; 95% CI: 1.28-2.98; p = 0.002) and OS (median, 169 vs. 261.1 months; HR: 2.56; 95% CI: 1.6-4.12; p < 0.001) in stage 2 and shorter OS (median, 65 vs. 183.1 months; HR: 3.25; 95% CI: 1.19-8.83; p = 0.021) in stage 3.

Conclusions: Elevated postoperative CEA indicates worse DFS and OS in patients with HR-positive/HER2-negative early breast cancer.