Unraveling emerging genes and their functional pathways in breast cancer susceptibility and progression

Paper Details

Review Paper 07/07/2025
Views (94)
current_issue_feature_image
publication_file

Unraveling emerging genes and their functional pathways in breast cancer susceptibility and progression

Shafee Ur Rehman, Shabeer Khan, Muhammad Arbaz Khan, Muhammad Usman, Moriom Shurovi
Int. J. Biosci. 27(1), 142-155, July 2025.
Copyright Statement: Copyright 2025; The Author(s).
License: CC BY-NC 4.0

Abstract

Breast cancer remains one of the leading causes of cancer-related morbidity and mortality among women worldwide. While mutations in BRCA1 and BRCA2 have long been recognized as key drivers of hereditary breast cancer, recent advances in genomic research have uncovered a growing set of additional genes such as PALB2, CHEK2, ATM, FANCM, and RAD51C—that contribute to breast cancer susceptibility. These genes are involved in critical molecular pathways, including homologous recombination DNA repair, cell cycle checkpoint control, apoptosis, and tumor suppression. Dysfunction in these pathways, often triggered by germline mutations, can lead to genomic instability, uncontrolled proliferation, and tumorigenesis. This review provides a comprehensive analysis of these emerging genetic factors, detailing their mechanisms of action, pathway interactions (e.g., BRCA–PALB2–RAD51 axis, ATM–CHEK2–p53 checkpoint signaling), and their impact on both familial and sporadic forms of breast cancer. We also discuss the clinical relevance of integrating multi-gene panels and polygenic risk scores (PRS) into personalized risk assessment and prevention strategies. By highlighting the molecular pathways disrupted by these gene mutations, we emphasize the importance of expanding genetic testing beyond BRCA1/2. A deeper understanding of these pathways not only refines risk stratification but also opens new avenues for targeted therapy, early detection, and tailored clinical management of breast cancer.

An Y, Gao D, He Y, Ge N, Guo J, Sun S, Wang C, Yang F. 2025. Guarding against digestive-system cancers: Unveiling the role of Chk2 as a potential therapeutic target. Genes & Diseases 12(1), 101191.

Ayoub A, Lapointe J, Nabi H, Pashayan N. 2023. Risk-stratified breast cancer screening incorporating a polygenic risk score: A survey of UK general practitioners’ knowledge and attitudes. Genes 14(3), 732

Billing D, Sfeir A. 2025. The role of microhomology-mediated end joining (MMEJ) at dysfunctional telomeres. Cold Spring Harbor Perspectives in Biology 17(2), a041687.

Bono M, Guadagni F, Vincenzi B, Russo A. 2024. Multigene panel testing in hereditary breast and ovarian cancer: An effective liquid biopsy approach to identify mutations in genes involved in the homologous recombination pathway.

Calabrese A, von Arx C, Tafuti AA, Pensabene M, De Laurentiis M. 2024. Prevention, diagnosis and clinical management of hereditary breast cancer beyond BRCA1/2 genes. Cancer Treatment Reviews 113, 102785.

Calheiros J, Silva R, Barbosa F, Morais J, Moura SR, Almeida S, Fiorini E, Mulhovo S, Aguiar TQ, Wang T, Ricardo S. 2025. A first-in-class inhibitor of homologous recombination DNA repair counteracts tumour growth, metastasis and therapeutic resistance in pancreatic cancer. Journal of Experimental & Clinical Cancer Research 44(1), 129.

Chatterji S, Niehues JM, van Treeck M, Loeffler CM, Saldanha OL, Veldhuizen GP, Cifci D, Carrero ZI, Abu-Eid R, Speirs V, Kather JN. 2023. Prediction models for hormone receptor status in female breast cancer do not extend to males: Further evidence of sex-based disparity in breast cancer. NPJ Breast Cancer 9(1), 91.

Chen Y, Zhu Z, Wu X, Li H, Guan W, Ren H. 2024. CHEK2 knockout is a therapeutic target for TP53-mutated hepatocellular carcinoma. Cell Death Discovery 10(1), 37.

Di Micco R, Esposito E, Accardo G, Sibilio A, Kouloura A, Costa M, Gentilini OD. 2023. Hereditary breast cancer non-CDH1 associated. In Hereditary Gastric and Breast Cancer Syndrome: CDH1: One Genotype with Multiple Phenotypes. Cham: Springer International Publishing, 361–386.

Fanale D, Corsini LR, Brando C, Randazzo U, Bono M, Pedone E, Perez A, Sciacchitano R, Cancelliere D, Piraino P, Giurintano A. 2024. BRCA-associated hereditary male cancers: Can gender affect the prevalence and spectrum of germline pathogenic variants? Frontiers in Oncology 14, 1414343.

Fanale D, Corsini LR, Brando C, Randazzo U, Bono M, Pedone E, Perez A, Sciacchitano R, Cancelliere D, Piraino P, Giurintano A. 2024. BRCA-associated hereditary male cancers: Can gender affect the prevalence and spectrum of germline pathogenic variants? Frontiers in Oncology 14, 1414343.

Ganatra H, Tan JK, Simmons A, Bigogno CM, Khurana V, Ghose A, Ghosh A, Mahajan I, Boussios S, Maniam A, Ayodele O. 2024. Applying whole-genome and whole-exome sequencing in breast cancer: A review of the landscape. Breast Cancer 31(6), 999–1009.

Garutti M, Foffano L, Mazzeo R, Michelotti A, Da Ros L, Viel A, Miolo G, Zambelli A, Puglisi F. 2023. Hereditary cancer syndromes: A comprehensive review with a visual tool. Genes 14(5), 1025.

Ge J, Tao M, Zhang G, Cai J, Li D, Tao L. 2024. New HCC subtypes based on CD8 Tex-related lncRNA signature could predict prognosis, immunological and drug sensitivity characteristics of hepatocellular carcinoma. Journal of Hepatocellular Carcinoma 13, 31–55.

Giordano C, Puzzo M, Malivindi R, Cristofaro D, Gelsomino L, Bonofiglio D, Capalbo C, Andò S, Barone I, Catalano S. 2025. Complex interplay between obesity and BRCA1/2‐associated breast cancer: An overview. Obesity Reviews e13969.

Glodzik D, Bosch A, Hartman J, Aine M, Vallon-Christersson J, Reuterswärd C, Karlsson A, Mitra S, Niméus E, Holm K, Häkkinen J. 2020. Comprehensive molecular comparison of BRCA1 hypermethylated and BRCA1 mutated triple negative breast cancers. Nature Communications 11(1), 3747.

Goldberg M, D’Aloisio AA, O’Brien KM, Zhao S, Sandler DP. 2020. Pubertal timing and breast cancer risk in the Sister Study cohort. Breast Cancer Research 22, 1.

Graffeo R, Rana HQ, Conforti F, Bonanni B, Cardoso MJ, Paluch-Shimon S, Pagani O, Goldhirsch A, Partridge AH, Lambertini M, Garber JE. 2022. Moderate penetrance genes complicate genetic testing for breast cancer diagnosis: ATM, CHEK2, BARD1 and RAD51D. The Breast 65, 32–40.

Graham E, Rampazzo L, Leung CW, Wall J, Gerőcz EZ, Liskovykh M, Goncharov N, Saayman X, Gundogdu R, Kanemaki MT, Masumoto H. 2025. The homologous recombination factors BRCA2 and PALB2 interplay with mismatch repair pathways to maintain centromere stability and cell viability. Cell Reports 44(2).

Hanker A, Rajkumar KS, He Z, Ohneda O, Nguyen HN, Kawahara M, Vuong CK, Fukushige M, Yamashita T. 2023. Women in breast cancer: 2022, volume II. 6.

Huber-Keener KJ. 2022. Cancer genetics and breast cancer. Best Practice & Research Clinical Obstetrics & Gynaecology 82, 3–11.

Joshi DC, Sharma A, Prasad S, Singh K, Kumar M, Sherawat K, Tuli HS, Gupta M. 2024. Novel therapeutic agents in clinical trials: Emerging approaches in cancer therapy. Discover Oncology 15(1), 342.

Kaur S, Singh D. 2024. Genetic contribution to breast cancer: A critical analysis of penetrance alleles as susceptible genes. Journal of Exploratory Research in Pharmacology 9(1), 60–64.

Khalizieva A, Moser SC, Bouwman P, Jonkers J. 2025. BRCA1 and BRCA2: From cancer susceptibility to synthetic lethality. Genes & Development 39(1–2), 86–108.

Kotamkar S, Jha RK, Bankar N. 2021. A brief research on cancer. Journal of Pharmaceutical Research International 33(38B), 323–329.

Lee JH. 2024. Targeting the ATM pathway in cancer: Opportunities, challenges and personalized therapeutic strategies. Cancer Treatment Reviews 129, 102808.

Liao YC, Wang LH, Hung MC, Cheng TC, Lin YC, Chang J, Tu SH, Wu CH, Yen Y, Hsieh YC, Chen LC. 2024. Investigation of the α9-nicotinic receptor single nucleotide polymorphisms induced oncogenic properties and molecular mechanisms in breast cancer. Human Molecular Genetics 33(22), 1948–1965.

Lim PX, Zaman M, Feng W, Jasin M. 2024. BRCA2 promotes genomic integrity and therapy resistance primarily through its role in homology-directed repair. Molecular Cell 84(3), 447–462.

Liu H, Dong A, Rasteh AM, Wang P, Weng J. 2024. Identification of the novel exhausted T cell CD8+ markers in breast cancer. Scientific Reports 14(1), 19142.

Liu YP, Zheng CC, Huang YN, He ML, Xu WW, Li B. 2021. Molecular mechanisms of chemo‐ and radiotherapy resistance and the potential implications for cancer treatment. MedComm 2(3), 315–340.

Luo C, Wang P, He S, Zhu J, Shi Y, Wang J. 2022. Progress and prospect of immunotherapy for triple-negative breast cancer. Frontiers in Oncology 12, 919072.

Mbuya-Bienge C, Pashayan N, Kazemali CD, Lapointe J, Simard J, Nabi H. 2023. A systematic review and critical assessment of breast cancer risk prediction tools incorporating a polygenic risk score for the general population. Cancers 15(22), 5380.

McClellan JC, Li JL, Gao G, Huo D. 2024. Expression- and splicing-based multi-tissue transcriptome-wide association studies identified multiple genes for breast cancer by estrogen-receptor status. Breast Cancer Research 26(1), 51.

Mendes J, Domingues J, Aidos H, Garcia N, Matela N. 2022. AI in breast cancer imaging: A survey of different applications. Journal of Imaging 8(9), 228.

Nabi N, Nisa MU, Khan MS, Gillani SQ. 2025. Role of signaling pathways regulating cell cycle progression in cancer. In Cell Signaling Pathways and Their Therapeutic Implication in Cancers. Singapore: Springer Nature Singapore, 357–393.

Nath A, Taneja R, Thadi YS, Sarveswaran G, Mathur P. 2024. A comparative study of incidence, mortality and disability adjusted life years (DALYs) for leading cancers in BRICS countries. ecancermedicalscience 18, 1773.

Neagu AN, Bruno P, Johnson KR, Ballestas G, Darie CC. 2024. Biological basis of breast cancer-related disparities in precision oncology era. International Journal of Molecular Sciences 25(7), 4113.

Neiger HE, Siegler EL, Shi Y. 2021. Breast cancer predisposition genes and synthetic lethality. International Journal of Molecular Sciences 22(11), 5614.

Nenclares P, Harrington KJ. 2020. The biology of cancer. Medicine 48(2), 67–72.

Pal M, Das D, Pandey M. 2024. Understanding genetic variations associated with familial breast cancer. World Journal of Surgical Oncology 22(1), 271.

Pappas K, Ferrari M, Smith P, Nandakumar S, Khan Z, Young SB, LaClair J, Russo MV, Huang-Hobbs E, Schultz N, Abida W. 2025. BRCA2 reversion mutation–independent resistance to PARP inhibition through impaired DNA prereplication complex function. Proceedings of the National Academy of Sciences 122(23), e2426743122.

Pasaol JC, Śmieszek A, Pawlak A. 2025. Exploring the therapeutic potential of BRCA1 and BRCA2 as targets in canine oncology: A comprehensive review of their role in cancer development and treatment. International Journal of Molecular Sciences 26(4), 1768.

Peleg Hasson S, Menes T, Sonnenblick A. 2020. Comparison of patient susceptibility genes across breast cancer: Implications for prognosis and therapeutic outcomes. Pharmacogenomics and Personalized Medicine 13, 227–238.

Pezzoli P, McCrory EJ, Viding E. 2024. Shedding light on antisocial behavior through genetically informed research. Annual Review of Psychology 76.

Podralska M, Sajek MP, Bielicka A, Żurawek M, Ziółkowska-Suchanek I, Iżykowska K, Kolenda T, Kazimierska M, Kasprzyk ME, Sura W, Pietrucha B. 2024. Identification of ATM-dependent long non-coding RNAs induced in response to DNA damage. DNA Repair 135, 103648.

Pourmasoumi P, Moradi A, Bayat M. 2024. BRCA1/2 mutations and breast/ovarian cancer risk: A new insights review. Reproductive Sciences 31, 1–1.

Qian H, Ali H, Karri V, Low JT, Ashley DM, Heimberger AB, Godley LA, Sonabend AM, Dmello C. 2025. Beyond DNA damage response: Immunomodulatory attributes of CHEK2 in solid tumors. Oncotarget 16, 445.

Rahmati M, Ebrahimi E, Shirkoohi R, Mahmoodzadeh H, Mohammanjad A, Malekisarvar H, Valizadeh Z, Dehghani M, Haghighat S, Marzban M, Zendehdel K. 2023. Study of CDH1 germline mutation in hereditary diffuse gastric cancer and lobular breast cancer: A multicenter study in Iran. Basic & Clinical Cancer Research 15(2), 130–139.

Rameshkumar A, ArunPrasanna V, Mahalakshmi V, Raja MR, Gopinath K. 2024. Recent advancement of analytical approaches for assessing Ataxia telangiectasia mutated kinase inhibitors in Ataxia telangiectasia: An overview. Process Biochemistry 144, 142–159.

Razack NA, Prabhuswamimath SC. 2024. Exploring high-penetrance genes in breast cancer associated genetic syndromes: Insights into genetic predisposition and clinical implications. International Journal of Health and Allied Sciences 13(1), 6.

Reid S, Pal T. 2020. Update on multi‐gene panel testing and communication of genetic test results. The Breast Journal 26(8), 1513–1519.

Rocca V, Lo Feudo E, Dinatolo F, Lavano SM, Bilotta A, Amato R, D’Antona L, Trapasso F, Baudi F, Colao E, Perrotti N. 2024. Germline variant spectrum in southern Italian high-risk hereditary breast cancer patients: Insights from multi-gene panel testing. Current Issues in Molecular Biology 46(11), 13003–13020.

Rodrigues LM, Maistro S, Katayama ML, Rocha VM, Lopez RV, Lopes EF, Gonçalves FT, Fridman C, Serio PA, Barros LR, Leite LA. 2024. Prevalence of germline variants in Brazilian pancreatic carcinoma patients. Scientific Reports 14(1), 21083.

Saundarya LA, Gunathilaka MD. 2024. Genetic predisposition to breast cancer: Understanding the role of susceptible genes and the impact of hereditary mutation. University of Colombo Review 5(2).

Shumilova S, Danishevich A, Nikolaev S, Krasnov G, Ikonnikova A, Isaeva D, Surzhikov S, Zasedatelev A, Bodunova N, Nasedkina T. 2024. High- and moderate-risk variants among breast cancer patients and healthy donors enrolled in multigene panel testing in a population of central Russia. International Journal of Molecular Sciences 25(23), 12640.

Swaminathan H, Saravanamurali K, Yadav SA. 2023. Extensive review on breast cancer: Its etiology, progression, prognostic markers, and treatment. Medical Oncology 40(8), 238.

Valentini V, Bucalo A, Conti G, Celli L, Porzio V, Capalbo C, Silvestri V, Ottini L. 2024. Gender-specific genetic predisposition to breast cancer: BRCA genes and beyond. Cancers 16(3), 579.

Varadhan V, Manikandan MS, Nagarajan A, Palaniyandi T, Ravi M, Sankareswaran SK, Baskar G, Wahab MR, Surendran H. 2024. Ataxia-Telangiectasia Mutated (ATM) gene signaling pathways in human cancers and their therapeutic implications. Pathology – Research and Practice 260, 155447.

Wang L, Jin Z, Master RP, Maharjan CK, Carelock ME, Reccoppa TB, Kim MC, Kolb R, Zhang W. 2022. Breast cancer stem cells: Signaling pathways, cellular interactions, and therapeutic implications. Cancers 14(13), 3287.

Wong SM, Apostolova C, Ferroum A, Alhassan B, Prakash I, Basik M, Martel K, Meterissian S, Fleiszer D, Wong N, Sadinsky MB. 2025. Chemotherapy receipt in affected BRCA1/2 and PALB2 carriers with operable breast cancer: The impact of early detection and pre-diagnostic awareness on clinical outcomes and treatment. Hereditary Cancer in Clinical Practice 23(1), 14.

Xu Z, Xie H, Song L, Huang Y, Huang J. 2025. BRCA1 and BRCA2 in DNA damage and replication stress response: Insights into their functions, mechanisms, and implications for cancer treatment. DNA Repair 118, 103847.

Zulfiqar A, Rauf A, Rasool E, Yousaf F, Nudrat A, Farooq M, Munawar A. 2024. Assessing long-term non-genetic risk factors for breast cancer. In: Asad M, Hussain R, Toor SI, Mughal MAS, Ahmad M (eds), Complementary and Alternative Medicine: Non-Conventional Therapies. Unique Scientific Publishers, Faisalabad, Pakistan, 122–129.

Related Articles

Lipid peroxidation and antioxidant status in 2,4,6-octatrienoic acid treated A549 and HCT-116 cancer cells

Shanmugam M. Sivasankaran, Raju Kowsalya, Krishnan Baskaran, Chakravarthy Elanchezhiyan, Int. J. Biosci. 27(1), 291-296, July 2025.

Public health implications of microbial contamination in registered slaughterhouses: A case study from La Union, Philippines

Carlo G. Fernandez, Harlene S. Fernandez, Priscilo P. Fontanilla Jr., Reinalyn D. Austria, Int. J. Biosci. 27(1), 272-290, July 2025.

Heterocyclic pyrazoline’s derivatives exhibiting promising potential antidiabetic activity

Mohd Akil, Farah Siddiqui, Amar Chandra Sharma, Mirza Masroor Ali Beg, Iqbal Azad, Firoz Hassan, Abdul Rahman Khan, Naseem Ahmad, Benjamin Siddiqui, Int. J. Biosci. 27(1), 244-271, July 2025.

Harnessing mangrove ecosystems for CO2 sequestration: Insights from remote sensing and GIS technologies

Anas Bin Firoz, Vaishaly Saranaathan, Swagata Chakraborty, Thoti Damodharam, Munisamy Govindaraju, Int. J. Biosci. 27(1), 225-243, July 2025.

Zootechnical performances of djallonké sheep supplemented with cocoa bean fragments, fruits, and leaves of Cajanus cajan in Côte D’ivoire

Ané François De Paul Atsé, Jacques Yao Datté, Sidiki Sangaré, Alassane Méïté, Int. J. Biosci. 27(1), 213-224, July 2025.

Cultivation and nutritional analysis of Pleurotus sp. from different substrates

P. Maheswari, P. Madhanraj, V. Ambikapathy, P. Prakash, A. Panneerselvam, Int. J. Biosci. 27(1), 204-212, July 2025.

Crinum asiaticum L. bulb extracts as a potential source of novel antimicrobial agents: An in-vitro study

K. Gowthaman, P. Prakash, V. Ambikapathy, S. Babu, A. Panneerselvam, Int. J. Biosci. 27(1), 194-203, July 2025.