Hypoxia-inducible factors in breast cancer: prognostic indicators and emerging biomarkers: narrative review.

The hypoxia-inducible factor (HIF) pathway is a critical regulator of cellular responses to low oxygen conditions, which are prevalent in solid tumors like breast cancer. Under hypoxic conditions, HIF transcription factors, particularly HIF-1α and HIF-2α, orchestrate various tumor-promoting processes, including angiogenesis, metabolic reprogramming, and metastasis. These adaptive responses contribute significantly to tumor progression and resistance to conventional therapies. As such, understanding the molecular mechanisms underlying the HIF pathway offers valuable insights into breast cancer biology and provides a foundation for the development of novel therapeutic strategies. Recent advancements in the identification of biomarkers associated with the HIF pathway have shown potential for improving prognosis and guiding therapeutic decisions. Biomarkers such as HIF-1α, vascular endothelial growth factor, glucose transporter 1, and carbonic anhydrase IX are linked to hypoxia-driven tumor behaviors and may serve as indicators of disease aggressiveness and patient outcomes. Their integration into clinical practice could enable more precise stratification of patients for HIF-targeted interventions, facilitating the move toward personalized treatment regimens in breast cancer care.