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Simple method for comparing reliability of two serum tumour markers in breast carcinoma.
  1. D P O'Brien,
  2. D B Gough,
  3. R Skehill,
  4. H Grimes,
  5. H F Given
  1. Department of Surgery, University College Hospital, Galway, Eire.


    AIMS--To compare the two breast tumour markers, CA15-3 and mucinous-like carcinoma associated antigen (MCA), using Receiver Operating Characteristic (ROC) curve analysis. METHODS--One hundred and ninety six patients "presenting" with breast carcinoma had serum CA15-3 and MCA concentrations measured. RESULTS--Using these markers as indicators of stage IV disease at the recommended laboratory level, true positive rates (TPR) and false positive rates (FPR) were obtained as follows: CA15-3 TPR = 75%, FPR = 7.4%, MCA TPR = 80%, FPR = 59.1%. By increasing the CA15-3 cutoff level to 45 U/ml, a TPR and FPR of 75% and 0.6%, respectively were obtained. By increasing the MCA cutoff level to 23 U/ml, a TPR and FPR of 65% and 2.3%, respectively, were obtained. CONCLUSIONS--Using ROC curve analysis shows that CA15-3 is a superior indicator of metastatic breast disease than MCA at recommended laboratory levels, and by altering the cutoff points, the specificity and sensitivity for both these markers can be improved.

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