Stromal subsets modulate T-cell infiltration in early breast cancer

Recent studies of the tumour microenvironment have elucidated the heterogeneity of stromal cells, with increasing evidence suggesting that stromal subsets play an important role in regulating anti-tumour immunity in breast cancer. However, the functional diversity of these cells within the tumour immune microenvironment and how they interact with immune cells in a spatial and clinical context remain poorly understood. We performed multiplex immunofluorescence on tumour microarrays from two cohorts consisting of 591 breast cancer patients to assess the abundance and spatial co-localisation of stromal and immune subsets and their correlation with clinicopathological features and patient outcomes. We found that stromal subsets are spatially distinct. We found that stromal cells were spatially distinct. A perivascular-like subset that was disseminated throughout the stroma rather than restricted to vessel-adjacent regions was enriched in an immune cold environment and associated with T-cell exclusion. Enrichment for PVLs was prognostic of poorer survival, independent of their role in T cell exclusion. An inflammatory-like cancer-associated fibroblast subset was associated with the stromal segregation of T cells and T cell exhaustion. Our findings highlight the differential impact of stromal subsets on immune infiltration and activation within the breast cancer TME with implications for patient outcomes.