The Implications of Hormonal Imbalances on Breast Cancer Pathogenesis Review

Breast cancer is one of the most prevalent cancers among women globally. The disease is due to a multifactorial and complex process that includes genetic aberrations such as BRCA1, BRCA2, and TP53, as well as epigenetic changes that result in uncontrolled cell proliferation. Hormonal signaling is crucial for the development of breast cancer. Estrogen and progesterone are important regulators, and abnormal levels of these hormones, often influenced by reproductive factors, lifestyle, and systemic inflammation prompted by obesity, are conducive to tumor growth. Furthermore, the crosstalk between hormonal pathways with growth factors such as insulin, IGF-1, and prolactin contributes to tumor aggressiveness and drug resistance. Early diagnosis is key to effective care with a multimodal approach including clinical evaluation, sophisticated imaging (mammography, ultrasound, and MRI), and histological verification. The molecular characterization of hormone receptors (ER, PR and HER2) is essential for the classification of cancer subtypes and for the implementation of personalized therapeutic strategies. Endocrine drugs, such as SERMs and AIs, have considerably improved the survival rates, but treatment resistance remains a major therapeutic challenge. This review highlights the role of hormonal dysregulation in breast cancer and the need for specific therapeutic strategies to overcome resistance and improve clinical outcomes.