乳腺癌是一种多方面、异质性的疾病，在了解其复杂的耐药机制和制定有效的治疗策略方面提出了重大挑战。这篇综述全面概述了乳腺癌背景下细胞外囊泡 (EV) 的复杂情况，强调了它们的不同亚型、生物发生以及在肿瘤微环境 (TME) 内细胞间通讯中的作用。讨论涵盖各个方面，从乳腺癌中的 EV 和基质细胞到它们对血管生成、免疫反应和化疗耐药的影响。探讨了 EV 生产在不同培养系统（包括二维 (2D)、三维 (3D) 和类器官模型）中的影响。此外，这篇综述深入研究了 EV 在乳腺癌中的治疗潜力，提出了新兴策略，例如用于基因传递的工程化 EV、用于靶向化疗的纳米平台以及破坏肿瘤衍生的 EV 作为治疗方法。了解 EV 在乳腺癌环境中的这些复杂相互作用对于识别耐药机制和开发新的治疗靶点至关重要。

Breast cancer, a multifaceted and heterogeneous disease, poses significant challenges in terms of understanding its intricate resistance mechanisms and devising effective therapeutic strategies. This review provides a comprehensive overview of the intricate landscape of extracellular vesicles (EVs) in the context of breast cancer, highlighting their diverse subtypes, biogenesis, and roles in intercellular communication within the tumour microenvironment (TME). The discussion spans various aspects, from EVs and stromal cells in breast cancer to their influence on angiogenesis, immune response, and chemoresistance. The impact of EV production in different culture systems, including two dimensional (2D), three dimensional (3D), and organoid models, is explored. Furthermore, this review delves into the therapeutic potential of EVs in breast cancer, presenting emerging strategies such as engineered EVs for gene delivery, nanoplatforms for targeted chemotherapy, and disrupting tumour derived EVs as a treatment approach. Understanding these complex interactions of EV within the breast cancer milieu is crucial for identifying resistance mechanisms and developing new therapeutic targets.