Multiple biological markers and breast carcinoma: A preliminary study in the detection of recurrent disease after primary therapy

The use of a selected group of biological markers in breast cancer patients who are disease free but at risk of relapse after mastectomy has potential for detecting recurrent tumor before there is clinical evidence. In this preliminary study, multiple materials were serially analyzed in the body fluids of patients without overt tumor but receiving adjuvant chemotherapy because of positive axillary nodes at surgery. The total frequency of elevated levels was determined and compared for those patients who remained disease free, for those who subsequently relapsed, and for a third group of patients with proven metastases. Frequency of elevation was directly proportional to increasing disease. Although differences in the relative frequency of individual materials was observed, the same trends with increasing tumor burden were found. The results suggest that the serial measurement of biological markers has potential for indicating the presence of occult disease. A nucleus of biological markers to be considered should include carcinoembryonic antigen, urinary hydroxyproline/creatinine ratio for bone lesions, and gamma-glutamyltranspeptidase for liver involvement.