INS and obesity due to melanocortin 4 receptor deficiency: Interestingly, in our study, the insulin pathway was not specifically associated with the TNBC subtype in the AA patients, which indicates its relevance in the etiology of breast cancer in general in this population, which may be directly correlated with the high incidence of obesity and other co-morbidities, such as diabetes and other metabolic syndromes in this population [67].