<p>Breast cancer (BC) continues to be the most frequently diagnosed malignancy and the primary cause of cancer-related deaths among women globally. The traditional treatment modalities, such as chemotherapy, surgery, and radiotherapy, are often associated with significant toxicity to healthy tissues and systemic side effects, highlighting the pressing need for safer and more targeted therapeutic strategies. Recently, microneedle innovation has become an evident alternative for delivering anti-neoplastic agents, offering minimally invasive, transdermal administration that can bypass hepatic metabolism and reduce systemic toxicity. Microneedle (MNs) arrays hold potential not only for drug delivery but also for vaccination, diagnostic sampling, and targeted therapy in BC management. However, despite these promising attributes, there exists a notable gap in the scientific literature specifically addressing the application of microneedles in breast cancer therapy, with relatively few comprehensive studies in this domain. This review aims to bridge that gap by summarizing recent advancements in MN-based strategies for breast cancer treatment. It highlights the ability of MNs to enable simultaneous drug loading, controlled release, and improved patient compliance through non-invasive administration. Furthermore, the review discusses MN properties, mechanisms of action, therapeutic benefits, relevant clinical trials, patents, and future challenges, thereby providing a valuable resource for researchers and promoting the translation of MN technology into clinical practice for breast cancer management.</p> Graphical abstract <p></p>