Hereditary breast cancer: emerging roles of non-coding RNAs

Breast cancer remains a major global health burden and is characterized by substantial molecular and clinical heterogeneity. In recent years, considerable progress has been made in elucidating the genetic and molecular mechanisms underlying breast cancer, particularly those associated with hereditary susceptibility. Advances in genomic and functional studies have further revealed the complex mutational landscape of breast cancer, including key alterations in tumor suppressor genes, oncogenic signaling pathways, and mutagenic processes. In addition, non-coding RNAs (ncRNAs) have emerged as important regulators of gene expression, influencing tumor progression and therapeutic resistance. Emerging strategies, including immunotherapy, precision medicine, and nanoparticle-based drug delivery systems, have significantly expanded treatment options and improved clinical outcomes. However, challenges such as tumor heterogeneity, drug resistance, systemic toxicity, and disparities in healthcare access continue to limit the effectiveness and broad implementation of these therapies. This review provides a comprehensive overview of the molecular mechanisms of breast cancer from a hereditary perspective, with a particular focus on genetic susceptibility, ncRNAs, and emerging therapeutic strategies. Additionally, it highlights current limitations and future directions, emphasizing the need for integrative approaches that combine genomic insights, advanced technologies, and personalized medicine to improve breast cancer prevention and treatment.