Abstract: This review systematically summarizes the unique metabolic mechanisms of breast cancer, their interactions with the tumor microenvironment (TME), and the latest advances in targeted therapies. The interplay between metabolic reprogramming and the TME underpins malignant progression and therapeutic resistance. Breast cancer cells reshape energy supply through the Warburg effect, aberrant fatty acid synthesis, and amino acid metabolism, while immune cells, fibroblasts, and the acidic milieu within the TME promote immune evasion and drug resistance via metabolic coupling. Although traditional strategies targeting key metabolic enzymes remain valuable, they are often insufficient to overcome metabolic adaptability. In recent years, combined metabolic and immunotherapeutic approaches have emerged as promising strategies: by reducing lactate accumulation, restoring T-cell function, and reprogramming tumor-associated macrophages and cancer-associated fibroblasts, these therapies can remodel the immunosuppressive microenvironment and enhance immunotherapy efficacy. The application of metabolomics and single-cell sequencing further elucidates breast cancer heterogeneity, providing a basis for individualized precision treatment. Future challenges include deciphering resistance mechanisms, developing highly selective metabolic inhibitors, and designing integrated multi-omics-based therapeutic regimens.

Key words: breast cancer, metabolic reprogramming, tumor microenvironment, tumor metabolism, immune suppression