As a malignant neoplasm exhibiting the highest global incidence among women，breast cancer continues to present significant therapeutic challenges despite markedly enhanced 5-year survival rates. Notably，treatment efficacy for aggressive subtypes such as triple -negative breast cancer remains suboptimal. This comprehensive review elucidates the intricate mechanisms within the breast tumor microenvironment（TME） through integrated metabolic and immunological perspectives，establishing metabolic reprogramming and immune evasion as fundamental drivers of disease progression. Tumor cells execute Warburg effect - mediated lactate overproduction，simultaneously fueling proliferative demands while acidifying the microenvironment to suppress anti - tumor activity of T cells and NK cells. Substantial heterogeneity in metabolic and immune signatures across molecular subtypes creates new paradigms for precision oncology. Our analysis delineates the metabolic-immune crosstalk network within breast TME，emphasizing the immunosuppressive roles of lactate and lipid metabolites. We critically examine translational barriers in precision medicine implementation，particularly addressing unresolved challenges of patient heterogeneity and underdeveloped biomarkers. By systematically exploring TME molecular mechanisms，identifying precision medicine limitations，and projecting future therapeutic trajectories，this review establishes a framework for overcoming current treatment impasses through innovations in combinatorial targeting，predictive modeling，and biomarker discovery.