Among the most prevalent and deadly types of cancer in the world, breast cancer is very critical. Gene therapy shows potential as a favourable treatment for breast cancer, despite a number of drawbacks including poor selectivity, immunological rejection and limited transport efficiency. Many cells spontaneously create exosomes, which are nanocarriers that have garnered a lot of interest due to their possible use in gene transfer. Exosomes have the ability to effectively transport nucleic acids, including DNA, mRNA, circRNA, siRNA and miRNA, to target cells and alter their biological functions. Because of their remarkable design flexibility, low immunogenicity and compatibility with live organisms, exosomes are ideal for gene therapy. The aim of this study is to provide a thorough evaluation of the current state of exosome-mediated gene delivery for breast cancer treatment, taking into account both its advantages and disadvantages. In this chapter, I provide a general information of exosome synthesis and properties, as well as their function in the development, spread and resistance to treatment of breast cancer. Here, I provide an overview of the existing approaches and tactics for encoding nucleic acids into exosomes, together with the variables influencing the precision and efficiency of their transportation. I also go over the many kinds of nucleic acid exosomes that are employed in breast cancer treatment, as well as their results and modes of action. We also discuss the latest advancements and uses of exosome-based delivery nanoplatforms, which improve the stability, targeting and functioning of exosomes by combining them with other nanomaterials or biomolecules. We conclude by outlining the existing state and difficulties of exosome-based clinical trials as well as the prospects for the future and possible medical uses based on exosomal gene nanoplatforms for drug delivery. I anticipate that this evaluation will provide insightful information and helpful recommendations for creating and refining exosome-mediated gene delivery in order to treat breast cancer.