Carcinoembryonic antigen, ferritin and alpha-one acid glycoprotein as diagnostic and prognostic tumor markers for carcinoma of the breast

Fifty female breast cancer patients and twenty normal healthy non-smoker females [control group] were selected to determine the CEA, ferritin and alpha one-acid glycoprotein in their sera. These three markers were measured prior to any treatment and at one, three and 6 months post therapy. They were classified according to the TNM classification; 4 patients [8%] had stage I. 19 patients [38%] had stage II, 21 patients [42%] had stage III and 6 patients [12%] had stage IV disease. Radical Mastectomy was performed in 19 patients [38%]. Modified Radical mastectomy in 15 patients [30%] and Extended Simple Mastectomy in 10 patients [20%]. Postoperative radiotherapy and adjuvant chemotherapy or hormonal therapy were given to the forty four patients. Six patients wih distant metastases were treated with combined radiotherapy and chemotherapy or hormonal therapy according to the site of metastases. Pretherapy measurements of these markers revealed highest sensitivity for CEA [50%] then ferritin [36%] and lastly alpha-1 AGP [28%]. The combined use of the three markers improved the sensitivity up to 68%, but the proportion of false negatives among these patients [32%] restricted their use in screening for breast cancer.A correlation between tumor size lymph node metastases and abnormal marker levels had been observed mainly with CEA, and to a less extent with alpha-1 AGP and ferritin. However the initial seum level of the 3 markers are of no prognostic value and the markers were not sensitive enough to detect recurrence where one patient only had distant metastases [4.3%] and 2 patients [8.6%] had signs of local recurrence during the follow up course. On the other hand, CEA was the only markers serving as a monitor for response to treatment

Comparative study of clinical examination, mammography and fine needle aspiration cytology in the diagnosis of breast tumours

The diagnostic acuracy of clinical examination, mammography and fine needle aspiration cytology was compared with definitive histological findings in 125 breast lumps. When suitable aspirates were obtained for cytological examination, the diagnostic acuracy of aspiration cytology was higher than clinical examination or mammography. A diagnostic acuracy of 100% was achieved when all three screening tests were in agreement. Cytology is useful in identifying malignancy when clinical findings suggest that the tumour is benign. The availability of acurati cytology has affected patient management in many ways. Mammography did not enhance the diagnostic acuracy of clinical examination and aspiration cytology in patients presenting with a breast lump and as a procedure with potential hazard, the benifit of routine mammography is questionable when an efficient cytological service is available