Endothelial dysfunction determines vascular mechanisms of metastatic progression in breast cancer

Breast cancer (BC) is one of the most common types of cancer among women, leading to death. More than 90% of deaths from BC are due to hematogenous metastases. In the cellular and tissue levels, the aggressiveness of BC is linked with epithelial–mesenchymal transition, leading to enhanced cell motility and spread in the bloodstream, leading to tumor expansion. This review focuses on the vascular mechanisms that facilitate metastatic dissemination in BC, highlighting the influence of blood vessels, hemodynamic forces, and vascular microenvironmental properties on tumor cell spread. Particular emphasis is placed on the role of endothelial dysfunction within common comorbid conditions and how these alterations may increase metastatic propensity. In addition, we discussed whether improving endothelial health and effectively managing comorbidities could help reduce metastatic progression.

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