Genetic heterogeneity and metabolic reprogramming in breast cancer

Breast cancer is the most prevalent cancer and the leading cause of cancer-related mortality among women. Recent breakthroughs in breast cancer therapeutics have significantly enhanced outcomes for hormone receptor-positive and HER2-negative subtypes. However, the emergence of drug resistance, particularly in triple-negative breast cancer, presents a formidable challenge. The intricate interplay of genetic and metabolic diversity within breast cancer cells is pivotal to its development. By reprogramming metabolic pathways, cancer cells can adapt and thrive, meeting the demands of survival, growth, and invasion. These metabolic shifts also play a key role in the development of resistance to conventional therapies. This review explores the genetic and metabolic complexities of breast cancer, emphasizing the diverse subtypes and their unique profiles. We examine how genetic variations and metabolic alterations contribute to breast cancer development and progression, influencing both treatment efficacy and resistance. By integrating insights into the genetic background and metabolic reprogramming of breast cancer subtypes, this review aims to highlight the genetic variations and metabolic alterations that contribute to the pathogenesis of breast cancer, with a vision of advancing more precise and effective targeted therapies as well as discovering of novel diagnostic and prognostic markers.