Core Viewpoint - The study reveals a mechanism of liver-breast metabolic communication that drives cancer progression, particularly highlighting the role of exosomes derived from non-alcoholic fatty liver disease (NAFLD) in promoting breast cancer development [9]. Group 1: Research Findings - Exosomes from fatty liver induce the release of free fatty acids in breast adipocytes, thereby promoting breast cancer progression [3][10]. - The study establishes a correlation between NAFLD and increased breast cancer risk in atypical hyperplasia individuals, as well as poor prognosis in breast cancer patients [4]. - The accumulation of fatty liver-derived exosomes in adipocytes contributes to the formation of a pro-tumor microenvironment in the breast [4]. Group 2: Mechanisms Involved - The targeting of adipocytes by exosomes is mediated by the interaction between ErbB4 and Nrg4 [4][10]. - TRMT10C in the exosomes is transferred to mitochondria, leading to m1A modification of mitochondrial mRNA, which suppresses the translation of ND5 and ND6, resulting in increased reactive oxygen species (ROS) levels and accelerated tumor progression [4][10]. Group 3: Prognostic Indicators - Plasma ErbB4-positive exosomes are identified as an independent prognostic indicator for breast cancer patients with NAFLD [5].