Utility of serum total and free prostate-specific antigen in combination with serum carbohydrate antigen 15-3 and carcinoembryonic antigen in breast tumours

Abstract

Background: Prostate Specific Antigen (PSA) is secreted by prostate gland as well as hormonally regulated tissues such as breast, ovaries and endometrium. We aimed to assess the utility of serum total and free PSA in combination with carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA 15-3) in diagnosis of breast cancer. Methods: Seventy two female patients (38 with benign breast disease and 34 with malignant breast disease) who were histologically, cytologically confirmed with diagnosis of primary breast tumours were investigated. Serum total prostate specific antigen (PSA), Free PSA, CEA, CA 15-3 were analysed by enzyme linked immunosorbent assay (ELISA) method. Diagnostic performance of markers was studied using receiver operating characteristic curve and logistic regression analysis. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: Patients with malignant breast cancer had significantly higher levels of all tumour markers compared to benign breast tumours. A significant decrease in total PSA, CEA and a statistically insignificant decrease in free PSA concentrations were seen in malignant breast cancer patients after surgery. Performance of total PSA was best among all the markers with 100% sensitivity, NPV, 94.7% specificity and 94.4% PPV. Conclusions: Serum total PSA is a good diagnostic marker to differentiate benign breast disease from malignant tumours compared to currently used CEA and CA 15-3.

Keywords

• breast cancer
• carbohydrate antigen 15-3
• carcinoembryonic antigen
• prostate-specific antigen
• tumour markers