Breast cancer and metabolic comorbidities: From epidemiology and molecular mechanisms to precision interventions

Figure 4 Systemic metabolic perturbations. Created in BioRender. Including hyperglycaemia, advanced glycation end products, and obesity - remodel the epigenetic landscape through DNA demethylation, histone acetylation, and non-coding RNA regulation, leading to activation of metastasis-associated matrix metalloproteinase-9 and cell cycle gene MCM5, along with dysregulation of obesity-associated genes such as FTO. These changes collectively drive oncogenic phenotypes including proliferation, invasion, and therapy resistance, while molecular interventions - via small molecules or biologics - target key nodes to suppress these epigenetically-driven malignant programmes. MMP: Matrix metalloproteinase; AGEs: Advanced glycation end products.