Serum biomarkers (CA 15-3, CEA) and hormonal receptor status as predictors of breast cancer recurrence

Background. Breast cancer is a heterogenous malignancy and is one of the leading causes of cancer-related mortality in women worldwide. Recurrence as a barrier to long-term survivorship and effective patient management is a formidable challenge. Aim of the study was to determine the prognostic value of circulating biomarkers (CA 15-3 and CEA) and the status of hormone receptors (estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2)) to predict recurrence of breast carcinoma, which will thus expand the diagnostic capacity of the disease in an early stage and guide personalized treatment plans. Materials and methods. The objectives of this study were to assess the predictive capacity of CA 15-3 and CEA serum biomarkers, as well as the hormonal receptor status (ER, PR, HER2) to predict breast cancer recurrence in this cross-sectional observational study, which was carried out in the period of January to October 2025 at Al-Habboubi Teaching Hospital, Iraq. It included female patients with a primary diagnosis of breast cancer that was confirmed by histopathology. ELISA biomarker analysis was performed on blood samples and immunohistochemistry on tumor specimens and equivocal cases of HER2 by FISH. Results. The study included female breast cancer patients (mean age 52.3 ± 10.4 years) and healthy controls (50.8 ± 9.8 years). Patients had higher body mass index (27.8 ± 4.2 vs. 26.5 ± 3.9 kg/m2, P = 0.045) and more family history of breast cancer (26.7 vs. 4 %, P < 0.001). Serum CA 15-3 and CEA levels were significantly elevated in patients (45.6 ± 12.3 U/mL, 7.8 ± 2.4 ng/mL) compared to controls. ER+ and PR+ were predominant, HER2+ was less common. CA 15-3 and CEA correlated strongly with recurrence risk, especially combined (r = 0.71, P < 0.001). Conclusions. High levels of serum CA 15-3 and CEA, as well as negativity on ER/PR are linked to increased recurrence of breast cancer. It indicates more aggressive tumor biology and hormonal regulation that may result in the usage of these biomarkers in the disease progression monitoring and prediction.