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MINI REVIEW article

Front. Immunol.

Sec. Systems Immunology

This article is part of the Research TopicMacrophages at the Crossroads of Fibrosis and ImmunosuppressionView all 10 articles

MiRNAs: a Call to Arms That Shapes the Plasticity of Tumor Associated Macrophages in Breast Cancer

Provisionally accepted
Valentina FogazziValentina Fogazzi1GIULIA COSENTINOGIULIA COSENTINO1Michele SommarivaMichele Sommariva2Angela GalardiAngela Galardi3Elisa Dell'OrtoElisa Dell'Orto1Serenella PupaSerenella Pupa1Cristian TaccioliCristian Taccioli4Marilena Valeria IorioMarilena Valeria Iorio1*
  • 1Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • 2Universita degli Studi di Milano, Milan, Italy
  • 3National Cancer Institute Foundation (IRCCS), Milan, Italy
  • 4Universita degli Studi di Padova, Padua, Italy

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Breast cancer (BC) remains a leading cause of cancer-related mortality, and a major contribution to tumor progression and resistance to therapies arise from tumor microenvironment (TME). Tumor is indeed able to shape a self-permissive TME, reprogramming the cellular components into allies. Tumor-associated macrophages (TAMs), abundant in BC TME, mainly acquire an immunosuppressive M2-like phenotype able to fuel tumor progression, immune evasion, metastasis and therapy resistance through a dynamic crosstalk with cancer cells. MicroRNAs, transferred via extracellular vesicles and exploited by the tumor to mold an immunesuppressive niche, act as central mediators of this bidirectional communication: tumor-derived miRNAs can reprogram macrophages toward an M2-like functional program, and TAM-derived miRNAs in turn promote and sustain cancer cell progression. This miRNA-orchestrated plasticity highlights TAMs as key TME regulators. Clinically, miRNA modulation offers promising strategies for TAM reprogramming, alongside their utility as prognostic biomarkers. Integrating miRNA-targeted TME interventions with conventional therapies holds the potential to overcome resistance in high-TAM BC subtypes.

Keywords: breast cancer, Immune Evasion, MicroRNAs, Tumor Microenvironment, Tumor-associated macrophages

Received: 21 Jan 2026; Accepted: 04 Feb 2026.

Copyright: © 2026 Fogazzi, COSENTINO, Sommariva, Galardi, Dell'Orto, Pupa, Taccioli and Iorio. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Marilena Valeria Iorio

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material