Traditional Chinese Medicine Cellular Plasticity in Breast Cancer: From Stemness and Dormancy to Metastatic Evolution

Introduction Breast cancer remains the most frequently diagnosed malignancy and a leading cause of cancer-related mortality among women worldwide. Despite advances in targeted therapies, therapeutic resistance, recurrence, and metastasis remain major challenges. Increasing evidence identifies cellular plasticity as a key driver of these processes, while Traditional Chinese Medicine (TCM), with its multi-component and multi-target pharmacology, has emerged as a promising strategy to modulate these adaptive networks. Methods This review summarizes the molecular mechanisms of cellular plasticity in breast cancer and discusses how TCM-derived bioactive compounds regulate these processes. It also highlights the contributions of multi-omics technologies, systems pharmacology, network pharmacology, and artificial intelligence in advancing TCM research. Unlike previous reviews that primarily focus on individual TCM compounds or specific breast cancer pathways, this review integrates TCM interventions across formula, herb, extract, and compound levels with cellular plasticity, emerging technologies, and translational challenges. Results TCM-derived bioactive compounds, including curcumin, berberine, baicalein, ginsenosides, tanshinone IIA, triptolide, honokiol, emodin, and wogonin, inhibit epithelial–mesenchymal transition, cancer stemness, tumor dormancy, therapy-induced plasticity, metabolic and immune reprogramming, and metastatic evolution through coordinated regulation of multiple oncogenic signaling pathways. Discussion Cellular plasticity provides a unifying framework for understanding breast cancer progression and therapeutic resistance. By simultaneously targeting multiple adaptive processes, TCM represents a promising systems-based therapeutic strategy. Integration of multi-omics, artificial intelligence, and precision oncology will further facilitate the mechanistic validation and clinical translation of TCM for personalized breast cancer management.