Breast cancer is the second leading cause of death for women worldwide. The heterogeneity of this disease presents a therapeutic challenge. Recent advances in molecular biology and immunology have led to highly targeted therapies. Targeted therapy aims to inhibit molecules supporting tumor progression, while immunotherapy enhances host immunity. This review provides an overview of clinical developments and advancements in targeted therapies (PARP inhibitors, CDK4/6 inhibitors, AKT inhibitors, angiogenesis inhibitors, FGFR inhibitors) and immunotherapies (immune-checkpoint blockade, vaccination, adoptive cell transfer) for breast cancer treatment, critically discussing successes, challenges, and future prospects.