As the first meta-analysis regarding the prognostic value of NAFLD on breast cancer survival, we enrolled seven studies with eight cohorts and 3684 patients, the results illustrated that NAFLD presence correlated with advanced age (> 50 years), higher BMI (> 25 kg/m2), lymph node involvement and hormone-receptor positivity. This evidence concerns the gene NR4A1 and metabolic dysfunction-associated steatotic liver disease.