Abstract: Breast cancer is one of the most common malignancies among women worldwide, with its incidence and mortality rates continuing to rise in recent years. Despite advancements in traditional treatment modalities such as surgery, chemotherapy, and targeted therapy, breast cancer patients still face significant challenges in long-term prognosis, particularly during tumor recurrence and metastasis. Recent breakthroughs in research on the tumor microenvironment (TME) have unveiled critical mechanisms underlying the occurrence, progression, and therapeutic resistance of breast cancer. Notably, metabolic reprogramming and immune evasion play pivotal roles in the biological processes of breast cancer. Breast cancer cells remodel their metabolism to support growth and regulate the local immune landscape through metabolic byproducts, promoting immune suppression and evasion. Moreover, distinct subtypes of breast cancer exhibit significant differences in their metabolic and immunological characteristics, offering both new opportunities and challenges for the application of precision medicine. This review explores the molecular mechanisms within the breast cancer TME from metabolic and immunological perspectives, examines key issues in precision medicine, and discusses potential future research directions and therapeutic strategies.