# Tissue Expression of Growth Differentiation Factor 11 in Patients with Breast Cancer

## TL;DR

This study finds that lower levels of GDF11 protein in breast cancer tissues are linked to more aggressive cancer features and certain patient characteristics.

## Contribution

The study reports novel associations between GDF11 expression and clinicopathological features in breast cancer patients, including molecular subtypes and blood parameters.

## Key findings

- GDF11 expression is significantly lower in tumorous tissues compared to DCIS and normal tissues.
- Triple-negative breast cancer patients show a loss of GDF11 expression.
- GDF11 levels correlate with tumor size, stage, Ki67 status, and red cell distribution width parameters.

## Abstract

Protein growth differentiation factor 11 (GDF11) plays crucial roles in cellular processes, including differentiation and development; however, its clinical relevance in breast cancer patients is poorly understood. We enrolled 68 breast cancer patients who underwent surgery at our hospital and assessed the expression of GDF11 in tumorous, ductal carcinoma in situ (DCIS), and non-tumorous tissues using immunohistochemical staining, with interpretation based on histochemical scoring (H-score). Our results indicated higher GDF11 expressions in DCIS and normal tissues compared to tumorous tissues. In addition, the GDF11 H-score was lower in the patients with a tumor size ≥ 2 cm, pathologic T3 + T4 stages, AJCC III-IV stages, Ki67 ≥ 14% status, HER2-negative, and specific molecular tumor subtypes. Notably, the patients with triple-negative breast cancer exhibited a loss of GDF11 expression. Spearman correlation analysis revealed associations between GDF11 expression and various clinicopathological characteristics, including tumor size, stage, Ki67, and molecular subtypes. Furthermore, GDF11 expression was positively correlated with mean corpuscular hemoglobin concentration and negatively correlated with neutrophil count, as well as standard deviation and coefficient of variation of red cell distribution width. These findings suggest that a decreased GDF11 expression may play a role in breast cancer pathogenesis.