Perioperative Monitoring of Serum p53 Antibody Titers in Japanese Women Undergoing Surgical Treatment After Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer

Original Article
Background: The clinicopathological relevance of serum p53 antibodies (s-p53-Abs) in advanced breast cancer is not well understood. We evaluated the clinicopathological importance of s-p53-Abs titers in patients after surgical treatment and neoadjuvant chemotherapy for breast cancer. Methods: We retrospectively analyzed the records of 43 consecutive female patients with primary locally advanced breast cancer who were surgically treated after neoadjuvant chemotherapy at Toho University Omori Medical Center between January 2010 and December 2014. S-p53-Abs, carcinoembryonic antigen (CEA), and cancer antigen (CA) 15-3 were assessed perioperatively, and the clinicopathological relevance of these tumor markers was analyzed. Results: Eleven (26%) patients were s-p53-Abs - positive; however, s-p53-Abs status was not associated with any clinicopathological feature. Three of these 11 patients developed recurrence. The rate of positive test results for CEA and/or s-p53-Abs was significantly higher than that for CEA alone (44% vs 21%, respectively; p = 0.04). In addition, the positive rate for CA15-3 and/or s-p53-Abs was higher than that for CA15-3 alone (53% vs 33%, respectively; p = 0.08). The s-p53-Abs titer decreased in 10 of 11 (91%) patients after surgery and increased in 1 patient, who later developed brain metastasis. Seven patients with positive s-p53-Abs titers seroconverted and did not develop recurrence. In contrast, s-p53-Abs titers remained positive in 3 patients, 2 of whom developed brain metastases. Conclusions: Perioperative monitoring of s-p53-Abs titers may be useful in detecting residual cancer cells. Extremely high s-p53-Abs titers suggest an increased risk of brain metastasis.