Elevated plasma CEA levels were observed in 14.2% (2114) of preoperative patients, 7.9% (3/38) of postoperative patients, and 70.9% (83/117) of patients with metastatic disease. Within these respective groups the simultaneous measurement of hCG, three polyamines and three minor nucleosides further enhanced the detection rates to 69.2%, 54.2%, and 98.6%. It was observed that in patients with at least one elevated CEA, measurement of sequential CEA levels paralleled the clinical course of metastatic disease in 25 patients. Prior to therapy for metastatic disease CEA levels > 5 ng/ml were associated with lower response rates and a shorter time to treatment failure than were levels 5 5 ng/ml. This effect was enhanced in patients also having an elevated hCG level. Hepatic and osseous involvement were associated with a greater incidence of CEA elevations than were pulmonary or soft tissue sites of involvement.
Cancer 42: 1507-15 11, 1978.
LEVATED CONCENTRATIONS OF THE car-E cinoembryonic antigen (CEA) described by Gold3 have been reported in approximately 70% of breast cancer patients with metastatic d i s e a ~e . ' , ~, ~, ~, ~~~~~~ Elevated levels have also been reported in approximately 20% to 30% of postoperative patients and preoperative pat i e n t ~. ' ~~~' ~~~' ~
The prognostic implications of an elevated postoperative CEA level in breast cancer were reported by Wang et a1.l' They found elevations in 34% of patients ten days postoperatively. The median time to recurrence was approximately 15 months when the CEA level was elevated and > 36 months in patients with normal levels. The present report outlines our experience with particular attention to CEA's prognostic usefulness in