The association of five preoperative serum tumor markers and pathological features in patients with breast cancer

Background The utility of frequently used serum tumor markers in breast cancer remains controversial. The study aimed to investigate the role of preoperative carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), cancer antigen 153 (CA153), cancer antigen 724 (CA724), and ferritin (FER) in the management of breast cancer and their relationships with pathological features. Methods A total of 804 patients with breast mass who underwent breast surgery and 305 healthy volunteers were enrolled. Preoperative serum levels of CEA, CA125, CA153, CA724, and FER were measured. And the pathological features of all the patients were recorded. The association of preoperative serum tumor markers and pathological features was analyzed. Results Among the 804 patients, 355 were identified as malignant cases and 449 as benign cases. CEA, CA153, and FER of patients with breast cancer were higher than those of healthy volunteer group and patients with benign breast diseases. The area under curve (AUC) of CEA, CA153, and FER for distinguishing patients with breast cancer and subjects with non-breast cancer was 0.688 (95% CI: 0.656-0.721), 0.609 (95% CI: 0.574-0.645), and 0.623 (95% CI: 0.586-0.660), respectively. CA153 correlated with tumor size, node status, and TNM stage, whereas CA125 with node status. No statistic differences of the five markers were observed among the four molecular subtypes. Conclusion Preoperative levels of CEA, CA153, and FER exhibit low diagnostic accuracy for breast cancer (stage I-III). CA153 correlates with tumor burden, suggesting its prognostic value. The five serum markers do not correlate with molecular subtypes.