Regulatory T Cells in Invasive Breast Cancer: Prognosis, Mechanisms and Therapy

Abstract

Regulatory T cells (Tregs) are a specialized subset of CD4+ T lymphocytes essential for maintaining immune tolerance and preventing autoimmunity. However, in breast cancer, tumors exploit Tregs to establish an immunosuppressive microenvironment that enables immune evasion, accelerates progression, and contributes to therapeutic resistance. This review synthesizes current evidence on the role of Tregs in invasive breast cancer (IBC), highlighting their prognostic significance across molecular subtypes, mechanisms of immune suppression, and impact on treatment response. We integrated mechanistic and clinical insights to discuss opportunities for Treg-targeted therapeutic strategies, with attention paid to challenges such as autoimmunity, compensatory resistance, and subtype-specific heterogeneity. Finally, we outline future directions, including biomarker-driven precision medicine, novel therapeutic combinations, advanced preclinical models, as well as potential artificial intelligence-assisted approaches that aim to selectively disrupt tumor-promoting Treg functions while preserving the systemic immune balance.