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Invited Critique
August 2001

Serum Levels of Transforming Growth Factor β1 in Patients With Breast Cancer—Invited Critique

Arch Surg. 2001;136(8):940. doi:10.1001/archsurg.136.8.940

Transforming growth factor β is a member of a superfamily of polypeptides with diverse and complex biological functions. The report by Sheen-Chen et al suggests an association between serum expression of TGF-β and breast cancer stage and grade of disease. However, as noted by the authors, analyses of the relationship between TGF-β and breast cancer have previously resulted in a number of conflicting reports.1-4 In fact, this study demonstrated no difference in TGF-β expression in patients with benign breast disease compared with patients with breast cancer. Some reports have demonstrated results completely contrary to the present report, finding decreased TGF-β serum expression, while others have reported results similar to that of Sheen-Chen et al, that decreased TGF-β receptor expression is associated with more advanced breast cancer. These latter studies seem more consistent with the well-recognized growth inhibitory effect of TGF-β on normal mammary epithelial cells. Such data are certainly consistent with a more general phenomenon of malignant disease; that is, regulation of tumor progression is multifactorial. While this report provides a reasonable addition to the already controversial literature on the subject of TGF-β and breast cancer, it aptly demonstrates the broader conclusion that determining reproducible relationships between tumor cell products and clinical prognosis is often difficult.

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