Gut Microbiota and Breast Cancer: Systematic Review and Meta-analysis

Overview

Journal Breast Cancer

Specialty Oncology

Date 2024 Dec 9

PMID 39652259

Authors

Guilherme Gamba

Tamy Colonetti

Maria Laura Rodrigues Uggioni

Laura Uggioni Elibio

Eduarda Leticia Balbinot

Rebeca Heinzen

Ana Cristina Lacerda Macedo

Antonio Jose Grande

Maria Ines da Rosa

Affiliations

Soon will be listed here.

Abstract

Background: The gastrointestinal microbiota can modulate systemic estrogens, potentially influencing estrogen-induced breast neoplasia development. This study aimed to assess alterations in the gut microbiota in breast cancer patients.

Methods: A search strategy was developed using the terms: "Microbiota," "Gastrointestinal Microbiome," "Breast Cancer," and synonyms. Ten observational studies were included.

Results: The total sample was 1730 women (929 cases and 801 controls). The meta-analysis of alpha diversity, assessed by the Shannon index, displayed that in the breast cancer group, the diversity of the gut microbiota was reduced compared to controls, with a standardized mean difference (SMD) of - 0.34 (95% CI - 0.59, - 0.10, I = 68%, p = 0.007). Regarding the premenopausal population, there was a significant reduction in the breast cancer group (SMD - 0.67, 95% CI - 1.06, - 0.28, I = 77%, p = 0.0009). In women with a body mass index (BMI) between overweight or obesity, no statistically significant difference was observed (SMD - 0.20; 95% CI - 0.51, 0.11; I 52%, p = 0.20). However, in women with a BMI greater than or equal to 18.5 and less than 25.0, there was lower diversity in women with breast cancer compared to controls (SMD - 0.49, 95% CI - 0.94, - 0.04; I 78%, p = 0.03).

Conclusions: The study found a significant difference in gut microbiota diversity between women with breast cancer and controls, supporting the growing evidence that the gut microbiota may play a role in mammary carcinogenesis.

References

Siegel R, Miller K, Wagle N, Jemal A . Cancer statistics, 2023. CA Cancer J Clin. 2023; 73(1):17-48. DOI: 10.3322/caac.21763. View

Chen W, Wei W, Yu L, Ye Z, Huang F, Zhang L . Mammary Development and Breast Cancer: a Notch Perspective. J Mammary Gland Biol Neoplasia. 2021; 26(3):309-320. PMC: 8566423. DOI: 10.1007/s10911-021-09496-1. View

Hanahan D . Hallmarks of Cancer: New Dimensions. Cancer Discov. 2022; 12(1):31-46. DOI: 10.1158/2159-8290.CD-21-1059. View

Perez N, Dorsen C, Squires A . Dysbiosis of the Gut Microbiome: A Concept Analysis. J Holist Nurs. 2019; 38(2):223-232. DOI: 10.1177/0898010119879527. View

Bhatt A, Redinbo M, Bultman S . The role of the microbiome in cancer development and therapy. CA Cancer J Clin. 2017; 67(4):326-344. PMC: 5530583. DOI: 10.3322/caac.21398. View

Chen J, Douglass J, Prasath V, Neace M, Atrchian S, Manjili M . The microbiome and breast cancer: a review. Breast Cancer Res Treat. 2019; 178(3):493-496. DOI: 10.1007/s10549-019-05407-5. View

Guyatt G, Oxman A, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336(7650):924-6. PMC: 2335261. DOI: 10.1136/bmj.39489.470347.AD. View

Aarnoutse R, Hillege L, Ziemons J, de Vos-Geelen J, de Boer M, Aerts E . Intestinal Microbiota in Postmenopausal Breast Cancer Patients and Controls. Cancers (Basel). 2021; 13(24). PMC: 8699039. DOI: 10.3390/cancers13246200. View

Byrd D, Vogtmann E, Wu Z, Han Y, Wan Y, Clegg-Lamptey J . Associations of fecal microbial profiles with breast cancer and nonmalignant breast disease in the Ghana Breast Health Study. Int J Cancer. 2021; 148(11):2712-2723. PMC: 8386185. DOI: 10.1002/ijc.33473. View

10.

Goedert J, Jones G, Hua X, Xu X, Yu G, Flores R . Investigation of the association between the fecal microbiota and breast cancer in postmenopausal women: a population-based case-control pilot study. J Natl Cancer Inst. 2015; 107(8). PMC: 4554191. DOI: 10.1093/jnci/djv147. View

11.

Goedert J, Hua X, Bielecka A, Okayasu I, Milne G, Jones G . Postmenopausal breast cancer and oestrogen associations with the IgA-coated and IgA-noncoated faecal microbiota. Br J Cancer. 2018; 118(4):471-479. PMC: 5830593. DOI: 10.1038/bjc.2017.435. View

12.

He C, Liu Y, Ye S, Yin S, Gu J . Changes of intestinal microflora of breast cancer in premenopausal women. Eur J Clin Microbiol Infect Dis. 2020; 40(3):503-513. DOI: 10.1007/s10096-020-04036-x. View

13.

Wu Z, Byrd D, Wan Y, Ansong D, Clegg-Lamptey J, Wiafe-Addai B . The oral microbiome and breast cancer and nonmalignant breast disease, and its relationship with the fecal microbiome in the Ghana Breast Health Study. Int J Cancer. 2022; 151(8):1248-1260. PMC: 9420782. DOI: 10.1002/ijc.34145. View

14.

Zhu J, Liao M, Yao Z, Liang W, Li Q, Liu J . Breast cancer in postmenopausal women is associated with an altered gut metagenome. Microbiome. 2018; 6(1):136. PMC: 6080540. DOI: 10.1186/s40168-018-0515-3. View

15.

Musgrove E, Sutherland R . Biological determinants of endocrine resistance in breast cancer. Nat Rev Cancer. 2009; 9(9):631-43. DOI: 10.1038/nrc2713. View

16.

Fuhrman B, Feigelson H, Flores R, Gail M, Xu X, Ravel J . Associations of the fecal microbiome with urinary estrogens and estrogen metabolites in postmenopausal women. J Clin Endocrinol Metab. 2014; 99(12):4632-40. PMC: 4255131. DOI: 10.1210/jc.2014-2222. View

17.

Plottel C, Blaser M . Microbiome and malignancy. Cell Host Microbe. 2011; 10(4):324-35. PMC: 3264051. DOI: 10.1016/j.chom.2011.10.003. View

18.

Belkaid Y, Hand T . Role of the microbiota in immunity and inflammation. Cell. 2014; 157(1):121-41. PMC: 4056765. DOI: 10.1016/j.cell.2014.03.011. View

19.

Wu A, Tseng C, Vigen C, Yu Y, Cozen W, Garcia A . Gut microbiome associations with breast cancer risk factors and tumor characteristics: a pilot study. Breast Cancer Res Treat. 2020; 182(2):451-463. PMC: 7297869. DOI: 10.1007/s10549-020-05702-6. View

20.

Pellegrini M, Ippolito M, Monge T, Violi R, Cappello P, Ferrocino I . Gut microbiota composition after diet and probiotics in overweight breast cancer survivors: a randomized open-label pilot intervention trial. Nutrition. 2020; 74:110749. DOI: 10.1016/j.nut.2020.110749. View