Decoding the endogenous metabolome of breast cancer: analytical approaches and chemometric intervention. a systematic review

Breast cancer (BC) is the leading cause of cancer mortality in females worldwide. Metabolomic approach has shown broad potential in recognizing the carcinogenic metabolites. This study aimed to systematically review cellular and clinical metabolomic studies in the past decade on BC. We summarized the pathways and metabolic biomarkers associated with BC. Scopus, PubMed, SAGE Journals, and Cochrane Library databases were searched for research papers on metabolomics of BC from January 2010 to January 2021. Two reviewers evaluated the data and study eligibility. The search identified 924 records. In total, 51 studies were included in the review (33 clinical and 19 cellular research) based on inclusion and exclusion criteria. Relevant data were extracted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The selected metabolomics studies analyzed tissue, serum, plasma, urine, and breath. A total of 21 metabolites (reported in ≥ 3 studies) were found to be prevalent in BC. Metabolite’s alterations involving glutamate, glutamine, lactate, choline, and taurine provide evidence of tumorigenesis. Glutaminolysis presented as the most significant pathway which highlighted the correlation of glutamine, glutamate, and glutaminase enzyme as potential biomarker for BC diagnosis. In conclusion, metabolomics enables in-depth identification of BC metabolic profile. The relative non-invasion and advantages of convenience in comparison with tissue biopsy and imaging screening, considered metabolomics as a relevant tool in early BC diagnosis. Collectively, this may lay foundation for understanding the progression and development of BC.