Biomaterial Database

Comparing the performance of CA 15-3 CSF to cytology in a cohort of patients with breast cancer leptomeningeal metastasis. 2018

Stacy M Kenyon, and Tifani L Flieth, and Alicia Algeciras-Schimnich

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, United States.

OBJECTIVE Leptomeningeal metastasis (LM) can occur as a late manifestation of breast cancer and has traditionally been diagnosed by CSF cytology; however, cytology suffers from low sensitivity and it is believed that many cases of LM go undiagnosed. Some studies have suggested the use of CA 15-3 in CSF (CA 15-3 CSF) to aid in the detection of LM. The purpose of this study was to compare the performance of CA 15-3 CSF to cytology for the detection and treatment monitoring of breast cancer LM. METHODS CA 15-3 CSF requests between 2014 and 2016 were retrospectively reviewed. Fifty-two measurements from nine patients were from our health system and had corresponding CSF cytology measurements. Concordance between CA 15-3 CSF and CSF cytology was calculated. For patients with quantifiable CA 15-3 CSF, sequential determinations of CA 15-3 and cytology were compared over time to assess correlation of CA 15-3 CSF concentration and cytology with disease status. RESULTS At the time of initial testing, seven of the nine patients (78%) had positive cytology. Two samples (22%) had quantifiable CA 15-3, both of which were also positive by cytology. The positive concordance between all cytology and CA 15-3 measurements was 9% (2/22), while negative concordance was 100% (30/30). Sequential CA 15-3 and cytology measurements showed a decrease in CA 15-3 that paralleled changes observed with cytology. CONCLUSIONS In this cohort of patients, CA 15-3 CSF performance was neither superior nor complementary to cytology for the detection of LM, nor did the combination of CA 15-3 CSF and cytology improve performance over cytology alone.

UI	MeSH Term	Description	Entries
D008577	Meningeal Neoplasms	Benign and malignant neoplastic processes that arise from or secondarily involve the meningeal coverings of the brain and spinal cord.	Intracranial Meningeal Neoplasms,Spinal Meningeal Neoplasms,Benign Meningeal Neoplasms,Leptomeningeal Neoplasms,Malignant Meningeal Neoplasms,Meningeal Cancer,Meningeal Neoplasms, Benign,Meningeal Neoplasms, Intracranial,Meningeal Neoplasms, Malignant,Meningeal Tumors,Neoplasms, Leptomeningeal,Neoplasms, Meningeal,Benign Meningeal Neoplasm,Cancer, Meningeal,Cancers, Meningeal,Intracranial Meningeal Neoplasm,Leptomeningeal Neoplasm,Malignant Meningeal Neoplasm,Meningeal Cancers,Meningeal Neoplasm,Meningeal Neoplasm, Benign,Meningeal Neoplasm, Intracranial,Meningeal Neoplasm, Malignant,Meningeal Neoplasm, Spinal,Meningeal Neoplasms, Spinal,Meningeal Tumor,Neoplasm, Benign Meningeal,Neoplasm, Intracranial Meningeal,Neoplasm, Leptomeningeal,Neoplasm, Malignant Meningeal,Neoplasm, Meningeal,Neoplasm, Spinal Meningeal,Neoplasms, Benign Meningeal,Neoplasms, Intracranial Meningeal,Neoplasms, Malignant Meningeal,Neoplasms, Spinal Meningeal,Spinal Meningeal Neoplasm,Tumor, Meningeal,Tumors, Meningeal
D009362	Neoplasm Metastasis	The transfer of a neoplasm from one organ or part of the body to another remote from the primary site.	Metastase,Metastasis,Metastases, Neoplasm,Metastasis, Neoplasm,Neoplasm Metastases,Metastases
D009363	Neoplasm Proteins	Proteins whose abnormal expression (gain or loss) are associated with the development, growth, or progression of NEOPLASMS. Some neoplasm proteins are tumor antigens (ANTIGENS, NEOPLASM), i.e. they induce an immune reaction to their tumor. Many neoplasm proteins have been characterized and are used as tumor markers (BIOMARKERS, TUMOR) when they are detectable in cells and body fluids as monitors for the presence or growth of tumors. Abnormal expression of ONCOGENE PROTEINS is involved in neoplastic transformation, whereas the loss of expression of TUMOR SUPPRESSOR PROTEINS is involved with the loss of growth control and progression of the neoplasm.	Proteins, Neoplasm
D001943	Breast Neoplasms	Tumors or cancer of the human BREAST.	Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D005260	Female		Females
D006651	Histocytochemistry	Study of intracellular distribution of chemicals, reaction sites, enzymes, etc., by means of staining reactions, radioactive isotope uptake, selective metal distribution in electron microscopy, or other methods.	Cytochemistry
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective
D018396	Mucin-1	Carbohydrate antigen elevated in patients with tumors of the breast, ovary, lung, and prostate as well as other disorders. The mucin is expressed normally by most glandular epithelia but shows particularly increased expression in the breast at lactation and in malignancy. It is thus an established serum marker for breast cancer.	Antigen CA-15-3,CA-15-3 Antigen,Episialin,Epithelial Membrane Antigen,Epithelial Mucin, Polymorphic,Muc1 Mucin,Polymorphic Epithelial Mucin,Antigens, CD227,CA 15-3 Antigen,CA 15.3 Antigen,CD227 Antigen,Antigen CA 15 3,Antigen, CA 15-3,Antigen, CA 15.3,Antigen, CA-15-3,Antigen, CD227,Antigen, Epithelial Membrane,CA 15 3 Antigen,CA-15-3, Antigen,CD227 Antigens,Membrane Antigen, Epithelial,Mucin 1,Mucin, Muc1,Mucin, Polymorphic Epithelial