<p>Breast cancer remains the most prevalent malignancy among women worldwide, presenting significant clinical challenges due to tumor heterogeneity, multidrug resistance (MDR), and the severe systemic toxicity associated with conventional chemotherapy. In the rapidly evolving field of nanomedicine, Metal–Organic Frameworks (MOFs) have emerged as a superior class of porous nanomaterials with exceptional potential for oncology applications. Distinguished by their ultra-high surface area, tunable porosity, and biodegradable nature, MOFs offer a versatile platform for encapsulating chemotherapeutic agents, genetic materials, and photosensitizers. This review provides a comprehensive overview of the recent advancements in MOF-based nanoplatforms for the diagnosis and treatment of breast cancer. We critically analyze the synthesis and functionalization strategies that enhance the stability and targeting capability of MOFs in the physiological environment. Furthermore, we highlight the development of stimuli-responsive drug delivery systems that utilize the unique tumor microenvironment (pH, redox, and ATP) for controlled release. Finally, the review discusses the dual role of MOFs as theranostic agents integrating bioimaging (MRI, CT, and optical imaging) with therapeutic modalities (chemotherapy, photothermal, and photodynamic therapy) and outlines the future perspectives for their clinical translation.</p> Graphical abstract <p></p>