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Carcinoembryonic antigen (CEA) assays (2536) were performed in 380 disease-free breast cancer patients after radical mastectomy. In the 334 evaluable patients with 3 or more determinations, the overall relapse rate after a median follow-up of 29 months was 11%. Of 203 patients with normal CEA values, 19 (9.3%) relapsed. In the 50 patients with the highest CEA value greater than 20 ng/ml, the relapse rate was 26%; in the 12 patients with gradually increasing CEA elevations it was 50%. However, CEA was unable to predict recurrence in N- patients. Premastectomy N+ was significantly associated with greater than 20 ng/ml or gradually increasing CEA values, suggesting the lack of an independent prognostic value of CEA in our patient population.
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