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PURPOSE: The main goals of the clinical use of tumor markers are to evaluate the adequacy of the treatment, monitor recurrence and follow up on the response to the treatment applied. The purpose of our study was to compare carcinoembryogenic antigen (CEA), the mucin associated tumor antigen CA15-3, and the tissue polypeptide antigen (TPS) in primary breast cancer and gauge the correlation of the prognostic factors. METHODS In 321 patients with breast cancer, the level of the serum tumor markers, CEA, CA15-3, and TPS, were determined preoperatively and during follow-up. RESULTS The sensitivity and specificity of tumor markers in patients with breast cancer were: CEA 44.6%, 94%; CA15-3 51.8%, 99%; and TPS 66.07%, 94%. CA15-3 and TPS increased with tumor size, the number of involved lymph nodes and progression of grade. CEA, CA15-3 and TPS were not related to estrogen or progesterone receptor status. Tumor markers in cases of organ or multiple metastasis were higher than in cases of local recurrence. Increasing levels of tumor markers were independent of the site of metastasis, where elevated levels of CA15-3 were primarily related to visceral metastasis. CONCLUSION The preoperative serum concentration of CA 15-3 and TPS appears to have a significant relation to the outcome in patients with early-stage breast cancer and may have a potential role in the rational selection of high risk patients for whom additional treatment and careful follow-up studies should be undertaken. Postoperative serial mea-surements of plasma CEA, CA15-3 and TPS are a cost- effective method to detect recurrent breast cancer and the association of these tumor markers may provide tumor profiles with a predictive value superior to a single parameter.