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Abstract Globally, Breast cancer is the second most common cancer, and the most commonly diagnosed malignancy in women, with variations in incidence and mortality among countries all over the world. In Egypt, it is the most common cause of cancer mortality in women (125, 126). In recent years, the tumor microenvironment (TME) has been a research hotspot, as it is composed of cellular and non-cellular elements that may affect the prognosis, and management of breast cancer cases (127). Many researches have shown that not only tumor cells affect cancer metastasis, however, other cells in TME greatly contribute to breast cancer prognosis and breast cancer cells interact with these cells around them in TME (128). Host Immune responses play a major role in the prognosis of breast cancer especially, tumor infiltrating lymphocytes (TILs) which have been reported to be clinically useful (1) and are easily measurable in a clinical setting(129). There are several TIL subsets, including cluster of differentiation (CD8)-positive T cells cytotoxic T lymphocytes, which have antitumor effects, and regulatory T cells (Tregs), which express forkhead box protein 3 (FOXP3) and negatively regulate immune responses; host immune responses to breast cancers are believed to be controlled by the functions of both of these cell types (130). It seems evident that with respect to the types of TILs, high levels of CD8+ T cells and low levels of FOXP3+ T cells are generally associated with good prognoses, their prognostic role in luminal breast cancer remains not evident (94). The prognosis of breast cancer cannot depend only on TIL levels based on H&E; however, the balance between CD8+ and FOXP3+ T cells is very important to be evaluated (109). In the present study 70 retrospective IDC cases of managed by Modified Radical Mastectomy without receiving neoadjuvant chemotherapy were studied. The cases were evaluated for CD8 and FOXP3 expression in TILS and CD8/FOXP3 ratio and were correlated with different clinicopathological parameters to suggest their role as prognostic factors in breast cancer. In the current study, in IDC cases the density of sTILs in the majority of cases showed score 2 intermediate infiltrates (≥ 10% and < 50%). This finding is in accordance with Noriko Goda et al. (111) and Reiko Fukui et al. (94) who reported that the majority of cases in their studies showed score 2(≥ 10% and < 50%) TILs. Of the studied 70 cases of IDC, 34 cases showed Carcinoma in situ (48.6%). Thirteen cases only from DCIS were available for examination, comedo type necrosis (30.8%) was the commonest pattern among the examined cases. Density of TILs examined circumferentially around DCIS in the majority of cases showed score 3. our result was in accordance with Miglena Komforti et al. who stated in their s |