EDITORIAL article
Front. Oncol.
Sec. Breast Cancer
This article is part of the Research TopicEpigenetic and Metabolic Regulators of Breast Carcinogenesis Volume IIView all 7 articles
Editorial Epigenetic and metabolic regulators of breast carcinogenesis, Volume II
Provisionally accepted
- 1College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- 2Universitatsklinikum Schleswig-Holstein Campus Lubeck, Lübeck, Germany
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. Mortality linked to high fasting plasma glucose (HFPG) and high body mass index (HBMI) increased by 0.41% and 2.75%, respectively. Age-period-cohort analysis indicated that BC mortality related to HBMI increased significantly with age, especially in women over 50, and surpassed the impact of HFPG. The risk associated with HBMI has steadily grown since 2005, while HFPG showed a temporary rise followed by a decline. Therefore, middle-aged and elderly women should be prioritized for HBMI and HFPG management to reduce BC mortality.The study by (Lu et al., 2025) extends the metabolic perspective of breast carcinogenesis by highlighting the link between coagulation activity and tumor metabolism. Cancer-associated changes in coagulation reflect underlying metabolic and epigenetic reprogramming within the tumor microenvironment. Thus, the prognostic value of the APTT/TT ratio may serve as a surrogate marker of broader metabolic adaptations driving BC progression. This retrospective study evaluated whether coagulation markers predict outcomes in 264 women with non-metastatic BC treated with surgery and adjuvant therapy at Suqian Hospital, China. Focusing on the APTT/TT ratio (activated partial thromboplastin time to thrombin time), the authors identified 1.4 as the optimal cut-off for predicting 5-year disease-free survival (DFS). Patients with APTT/TT ≥ 1.4 had significantly shorter DFS. A multivariate Cox analysis elevated APTT/TT (Hazard Ratio (HR) ≈4.1) and lymph-node metastases (HR≈2.3) were independent adverse prognostic factors, whereas tumor size lost significance. The study concludes that APTT/TT is a low-cost, accessible biomarker that, combined with lymph-node status, improves risk stratification in BC after comprehensive therapy, though validation in larger prospective cohorts is needed. Although the study primarily focuses on coagulation dynamics, it demonstrates cancer-associated hypercoagulability, as a result of a broader reprogramming of cellular energy balance, inflammation, and the tumor microenvironment.
Keywords: Breast cancer;, CHD4, MicroRNAs, coagulation markers, tumor microenvironment., metabolic reprogramming, Epigenetic regulation
Received: 15 Oct 2025; Accepted: 18 Nov 2025.
Copyright: © 2025 Saber-Ayad, Elemam, Talaat and Busch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Maha Mohamed Saber-Ayad, msaber@sharjah.ac.ae
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