Cellular Pathways and Biomarkers in Breast Cancer: Insights into HPV+ Association and Prognostic Significance Shortened title: Pathways and Biomarkers in HPV-Breast Cancer

Breast cancer is one of the leading global neoplasms and represents a primary form of cancer affecting women. The role of HPV in breast cancer development is acknowledged, yet the underlying mechanism remains incompletely understood. Biomarkers are crucial tools for diagnosis, prognosis, and disease monitoring, encompassing HPV-associated cancers. While hormonal receptors, Ki-167, and HER2 are well-established in breast cancer, additional markers assume significance, particularly in aiding disease monitoring, thereby facilitating the categorization and targeting of patients within specific risk cohorts. Infectious and carcinogenic processes disrupt the activity of diverse signaling pathways. Signaling through pro-inflammatory pathways, notably linked to IL-6 overexpression, is prominently documented in these cases, along with the activation of NF-κB, β-catenin/Wnt, and Pi3/AKT signaling pathways. This review delineates the main altered pathways in HPV-positive breast cancer. The study of this molecular landscape can help the identification of suitable biomarkers for assisting the follow-up of HPV-positive breast cancer. Furthermore, it unveils potential targets warranting exploration for targeted therapies directed at breast cancer.