Breast cancer is one of the most prevalent cancers among women worldwide and poses a growing threat in South Asia, particularly in countries like India, Pakistan, and Bangladesh. This review highlights heavy metal contamination as a potentially significant material that is an overlooked risk factor in breast carcinogenesis, outlines mechanistic insights into their biological effects, and advocates for region-specific research and policy intervention. The risk of breast cancer in women is also linked with genetic, hormonal, and lifestyle factors. However, the role of environmental contaminants, particularly toxic heavy metals, like Arsenic (As), Cadmium (Cd), Lead (Pb), Chromium (Cr), Mercury (Hg), and Nickel (Ni), can not be ignored because of their untreated discharges in agriculture and land soil, specifically in the India, Pakistan, and Bangladesh is a common experience. These metals, primarily released through industrial emissions, agricultural runoff, and urban pollution, exhibit carcinogenic properties through mechanisms including oxidative stress, endocrine disruption, and DNA damage. The persistence of heavy metals in soil, water, and food chains, especially rice and vegetables, elevates chronic exposure risks among South Asian women, who often live in proximity to polluted environments and consume locally grown produce. Case studies in cancer from these regions’ focus areas, such as the Malwa region in India and industrial zones in Bangladesh, further support the association between heavy metal contamination and elevated breast cancer risks in women of these regions. An effort has been made in the present review to merge current evidence on heavy metal-induced carcinogenesis, highlight exposure pathways unique to South Asia, and discuss emerging mitigation strategies, including bioremediation, regulatory enforcement, and public health interventions.

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