Abstract

Breast cancer is the most common malignancy in women globally. The increasing worldwide incidence of this type of cancer illustrates the challenge it represents for healthcare providers. Therefore, new tumor markers are constantly being sought. The aim of this study was to assess plasma concentrations and the diagnostic power of VEGF in 100 patients with early-stage breast cancer, both before and after surgical treatment and during a three-year follow-up. The control groups included 50 subjects with benign breast tumors (fibroadenoma) and 50 healthy women. The VEGF concentration was determined using enzyme-linked immunosorbent assay (ELISA) and the CA 15-3 concentration was determined by chemiluminescent microparticle immunoassay (CMIA). We observed significantly higher preoperative plasma concentrations of VEGF and CA 15-3 in patients with breast cancer. VEGF, similar to CA 15-3, demonstrated high diagnostic utility in the assessment of the long-term efficacy of surgical removal of the tumor. Determinations of VEGF had the highest diagnostic usefulness in the detection of breast cancer recurrence (SE 40%, SP 92%, PPV 67%, NPV 79%). Additionally, the highest values of SE, NPV and AUC were observed during the combined analysis with CA 15-3 (60%; 84%; 0.7074, respectively). Our study suggests a promising diagnostic utility of VEGF in the early stages of breast cancer and in the evaluation of the efficacy of the surgical treatment of breast cancer as well as the detection of breast cancer recurrence, particularly in a combined analysis with CA 15-3 as a new diagnostic panel.

Highlights

  • Breast cancer (BC) is the most common malignant neoplasm in women and a major global problem

  • Plasma Levels of vascular endothelial growth factor (VEGF) in Patients with Breast Cancer before and after Surgery, Classification According to the Tumor Stage

  • The present study demonstrated that in patients with stage I BC, the concentrations of VEGF (121.84 pg/mL) and the reference marker (20.14 U/mL) were statistically significantly higher than in the healthy controls (80.44 pg/mL; 15.94 U/mL; p = 0.008; p = 0.045, respectively)

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Summary

Introduction

Breast cancer (BC) is the most common malignant neoplasm in women and a major global problem. The early detection of neoplastic lesions as well as recurrent and metastatic cancer is crucial to cancer outcomes. Significant improvements in tumor detection have been achieved due to the application of imaging techniques, including ultrasound and magnetic resonance imaging (MRI), and biochemical tests. The American Society of Clinical Oncology guidelines include markers such as the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) as useful and non-invasive tests that can help determine the prognosis and further treatment, and markers such as CEA and CA15-3 in the monitoring of treatment in BC. The effectiveness of imaging modalities in detecting small neoplastic lesions is limited and the utility of biomarkers is still a subject of debate within the scientific community [3,4,5]

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