Spatially Resolved Obesity-Driven Molecular Changes in Early Breast Cancer

The epithelial component was accompanied by a fibro-inflammatory stromal signature and an immunosuppressive niche characterized by B cell depletion and M2 macrophage enrichment. Furthermore, SULF2, an extracellular endosulfatase involved in extracellular matrix organization and signaling, was consistently upregulated within the obese epithelium, providing a plausible link between metabolic stress and structural remodeling.

Collectively, these data indicate obesity-associated differences consistent with an alternative invasive transcriptional program that is less dominated by classical proliferative drivers in this cohort. Consequently, standard prognostic markers may be context-dependent, highlighting the need to integrate metabolic health into precision risk stratification.