{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:44:31Z","timestamp":1787244271892,"version":"build-2736575974"},"reference-count":150,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Breast Cancer Research Institute","award":["RGF-019"],"award-info":[{"award-number":["RGF-019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The advent of breast cancer molecular subtyping has transformed management, enabling treatment personalisation and de-escalation beyond traditional stage-based approaches. Established biomarkers, such as Ki-67 in luminal disease, HER2 amplification, and PD-L1 expression in triple-negative breast cancer, underpin seminal clinical trials yet remain imperfect predictors of response and long-term outcome. MicroRNAs have emerged as promising next-generation biomarkers and therapeutic tools. As master regulators of gene expression, both tumour-derived and circulating microRNAs can refine diagnosis and molecular subclassification, inform prognosis and therapeutic selection, act as treatment sensitisers, and potentially serve as direct therapeutic targets. Well-characterised miRNAs such as miR-221 have been implicated in endocrine resistance, while recent liquid-biopsy approaches have enabled the identification of circulating miR-145 and exosomal miR-155 as predictors of pathological complete response in HER2-positive disease. Their detectability in tissue, blood and other biofluids offers a minimally invasive means to dynamically monitor cancer behaviour and response, supporting more precise therapeutic decision-making. This review synthesises the current evidence for miRNA-based biomarkers across oestrogen-receptor positive, HER2-positive and triple-negative breast cancer and outlines their potential integration into biomarker-driven clinical trial designs and personalised treatment strategies.<\/jats:p>","DOI":"10.3390\/ijms27093996","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:03:47Z","timestamp":1777536227000},"page":"3996","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["MicroRNA-Directed Biomarkers and Breast Cancer Therapeutics\u2014Potential to Advance Personalised Approaches in Clinical Trials"],"prefix":"10.3390","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8251-5291","authenticated-orcid":false,"given":"Luis","family":"Bouz Mkabaah","sequence":"first","affiliation":[{"name":"Department of Surgery, The Lambe Institute for Translational Research, University of Galway, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1627-4297","authenticated-orcid":false,"given":"Eoin P.","family":"Kerin","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Lambe Institute for Translational Research, University of Galway, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew G.","family":"Davey","sequence":"additional","affiliation":[{"name":"Royal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02 YN77 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6468-8927","authenticated-orcid":false,"given":"Eleftheria","family":"Filandrianou","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Lambe Institute for Translational Research, University of Galway, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-9205","authenticated-orcid":false,"given":"Vinitha","family":"Richard","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Lambe Institute for Translational Research, University of Galway, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Kerin","sequence":"additional","affiliation":[{"name":"Department of Surgery, The Lambe Institute for Translational Research, University of Galway, H91 YR71 Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref_1","first-page":"7","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J. 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