Metabolomics in Breast Cancer: Insights into Treatment Responses, Disease Progression, and Prognostic Assessment

Alterations in metabolic pathways are a hallmark of cancer and play a pivotal role in breast cancer development and progression. The inherent metabolic heterogeneity of breast cancer contributes to differences in therapeutic response and patients’ prognosis. Clinical metabolomics has emerged as a promising approach for identifying metabolic biomarkers that reflect tumor biology, treatment-related changes after diagnosis, and patients’ outcomes. This review summarizes the metabolomic profiles of breast cancer patients, using various biological materials and analytical methods, to assess their potential role as biomarkers for monitoring therapeutic response, adverse treatment effects, tracking disease progression, and predicting prognosis. Metabolomic shifts generate unique signatures with promising potential as biomarkers for evaluating treatment response, monitoring therapeutic adverse effects, disease progression, and predicting clinical outcomes in breast cancer patients. Biological matrices, such as serum, plasma, and tumor tissue, were commonly used in both untargeted and targeted metabolomics approaches. Liquid chromatography-mass spectrometry is the most commonly used analytical method in clinical metabolomics studies. Altered metabolites were identified and linked to metabolic pathways, particularly amino acids, glucose, and fatty acids metabolism. When integrated with genomic and transcriptomic data, these metabolic fingerprints offer a multidimensional perspective on disease trajectory, thereby enhancing patient stratification and informing personalized therapeutic strategies.