Breast cancer and tumor microenvironment: the influence of cancer-associated fibroblasts on drug resistance and treatment efficacy

Breast cancer, one of the most diagnosed cancers in women worldwide, is a heterogeneous and complex disease that has also been found to arise from the interaction between cancer cells and the tumor microenvironment (TME). The tumor microenvironment plays a crucial role in breast cancer progression and metastasis. Cancer-associated fibroblasts (CAFs), the main component of the TME, exhibit a high degree of heterogeneity, which contributes to the complexity of TME in breast cancer. CAFs, in addition to promoting tumor growth and invasion through various mechanisms, are also involved in the development of drug and therapeutic resistance in breast cancer, making them the perfect target for a potential therapeutic strategy. The aim of my thesis is to demonstrate how CAFs are key components in the tumor microenvironment of breast cancer, analyzing their main roles and the different interactions with tumor cells that make them capable of enhancing their aggressiveness and modulating the response to therapy.