Abstract
Breast cancer ranks as the fifth-most-prevalent malignancy worldwide, characterized by high heterogeneity and multifactorial etiology across molecular subtypes. Despite advancements in conventional therapies, including surgery and chemotherapy, persistent challenges such as treatment-related adverse effects and acquired drug resistance necessitate alternative therapeutic strategies. Matrine, a naturally occurring alkaloid derived from Sophora flavescens, has demonstrated significant anticancer potential through multiple mechanisms. Experimental evidence indicates that matrine exerts inhibitory effects on tumor cell proliferation, promotes apoptosis, and attenuates metastatic progression via modulation of critical signaling pathways, particularly PI3K/Akt, JAK/STAT, NF-κB, MAPK/ERK, and Wnt/β-catenin. This review systematically examines subtype-specific responses to matrine treatment, highlighting its potential utility in precision oncology for distinct breast cancer classifications. Furthermore, we evaluate matrine's capacity to synergize with standard chemotherapeutic regimens, potentially overcoming drug resistance while reducing required dosages. By integrating current preclinical and clinical findings, this analysis provides new perspectives on matrine's therapeutic applications and underscores the imperative for translational studies to establish optimized treatment protocols for clinical implementation.