Breast Cancer Management: Integrating Genomics, Targeted Therapy, and Immuno-Oncology

Abstract

Breast cancer remains one of the most prevalent malignancies worldwide, contributing substantially to cancer-related morbidity and mortality among women. Over the past two decades, advances in genomics, molecular profiling, and translational oncology have transformed breast cancer management from a conventional, histology-driven approach to one increasingly guided by precision medicine. The integration of genomic technologies has enabled the identification of actionable mutations, predictive biomarkers, and molecular subtypes that inform both prognosis and therapeutic decision-making. Targeted therapies, particularly those directed against HER2, PI3K/AKT/mTOR signaling, and cyclin-dependent kinases, have reshaped the therapeutic landscape by improving survival outcomes and minimizing systemic toxicity. More recently, immuno-oncology strategies, including immune checkpoint inhibitors, tumor-infiltrating lymphocyte therapies, and cancer vaccines, have expanded therapeutic possibilities, especially in triple-negative breast cancer (TNBC), a traditionally hard-to-treat subtype. This manuscript provides a comprehensive review of breast cancer management, focusing on the integration of genomics, targeted therapy, and immuno-oncology within clinical practice. It highlights current standards of care, key molecular insights, translational research, and ongoing clinical trials while also emphasizing future perspectives for achieving durable responses and personalized cancer therapy.