Carcinoembryonic antigen as a monitor of recurrent breast cancer

Carcinoembryonic antigen (CEA) test was performed at the time of diagnosis in 136 patients with early operable breast carcinoma (stage I = 65, stage II = 71). Only 4% had CEA levels greater than 5 ng/ml. Patients with axillary metastasis (stage II) had higher incidence of abnormal CEAs than those with disease localized to the breast (stage I). Follow-up CEA tests were performed on 243 patients after mastectomy. In this group, 50 patients developed recurrent disease and 48% had elevated CEA levels. Patients with chest-wall recurrences rarely had abnormal CEAs, while those with visceral metastasis had higher levels. Among the 193 patients known to be without recurrence, 10% also had elevated CEAs. Excluding inflammatory, hepatic, and renal diseases, the most common medical conditions which could explain such false elevations are diabetes, hypertension, and organic heart disease.