Breast cancer is the leading cause of death among women and the second largest cause of mortality in the entire population worldwide. This review investigated how breast cancer is patho-physiologically associated with obesity which is defined by body mass index ≥30 kg/ and metabolic syndrome which leads to type 2 diabetes in pre and postmenopausal women. It also addressed the controversy relating the definition of BMI. The biological markers in breast cancer currently in use are ER, PR, HER2, uPA, and PAI-1. This study looked into future of predictive and prognostic biomarkers, such as exosome by altering interaction of distant cancer cells in the tumor microenvironment and the breast cancer progress.