{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:06:39Z","timestamp":1784700399629,"version":"3.55.0"},"reference-count":100,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    Breast cancer remains the most prevalent malignancy among women worldwide, with approximately 2.3 million new cases diagnosed annually, accounting for nearly 12% of all cancer diagnosis globally. Increasing evidence highlights the tumor microenvironment (TME) as a dynamic and interactive ecosystem that governs tumor behaviour. This review consolidates emerging evidence that positions cell competition as a critical regulator of clonal dynamics within the breast cancer TME. We examine how breast cancer stem cells (BCSCs), defined by CD44\n                    <jats:sup>+<\/jats:sup>\n                    \/CD24\n                    <jats:sup>-<\/jats:sup>\n                    phenotype and elevated ALDH activity, acquire enhanced fitness through MYC amplification and dysregulation of Hippo\/YAP, Wnt\/\u03b2-catenin and Notch signaling pathways. In parallel, we analyze the role of immune cell populations including tumor-associated macrophages, cytotoxic T lymphocytes, natural killer cells and myeloid-derived suppressor cells in shaping competitive interactions through resource limitation and immuno-suppressive signaling. We further explore metabolic competition, highlighting the Warburg effect, reverse Warburg effect and lactate-mediated immuno-suppression as central regulators of cellular fitness, alongside contributions from cancer-associated fibroblasts, extracellular matrix remodeling and exosome-mediated communication. The novelty of this study lies in integrating cellular, metabolic and stromal dimensions of competition into a unified framework and extending the concept beyond tumor cells to include immune and non-cellular components. Cumulatively, this study identifies competitive cellular fitness as a central and targetable driver of therapeutic resistance and tumor recurrence in breast cancer.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1861308","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:53:23Z","timestamp":1784699603000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cell competition within breast tumor microenvironment: emerging role of cancer stem cells and immune cells in tumor progression and therapeutic implications"],"prefix":"10.3389","volume":"16","author":[{"given":"Esha","family":"Pal","sequence":"first","affiliation":[{"name":"Department of Genetic Toxicology, Krish Biotech Research Private Limited","place":["Kalyani, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sovan","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, National Institute of Technology","place":["Warangal, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aishwarya","family":"Guha","sequence":"additional","affiliation":[{"name":"Department of Biotechnology, Swami Vivekananda University","place":["Kolkata, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2025.1622954","article-title":"Global burden and projections of breast cancer incidence and mortality to 2050: a comprehensive analysis of GLOBOCAN data","volume":"13","author":"Freihat","year":"2025","journal-title":"Front Public Health"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers18101544","article-title":"The 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