Microbiome disharmony: a catalyst in breast cancer progression and influencing surgical outcomes

Breast cancer is the most common cancer amongst women globally and has been traditionally linked with factors such as genetics, hormones, and lifestyle. The oncogenic processes are greatly modulated by microbes in the body. Breast tissue, once thought to be sterile, is now recognized as harboring a unique microbiome. The dysbiosis of the gut and breast microbiome is a driving force in breast cancer, promoting tumorigenesis and also altering surgical outcomes. Such dysbiosis often leads to fewer beneficial microbial species. It also results in more pro-inflammatory or genotoxic bacteria. These changes create an environment that supports tumor growth. Microbial enzymes, such as β-glucuronidase, further complicate the landscape in the breast-gut axis, creating a hormonal milieu conducive to tumor growth. Differences in microbial patterns between healthy and cancerous breast tissues suggest their potential to serve as a microbial fingerprint for malignancy and may aid in early diagnosis and prognosis of breast cancer. Surgical interventions like implants and mastectomies can disrupt the local microbiota, increasing postoperative risk and altering cancer trajectories. Postoperative infections and complications are now connected to microbial imbalances, which suggests the consideration of breast and gut microbiomes in surgical planning and recovery. The present review navigates through pathogenesis, as well as treatment approaches, including immunotherapy, probiotics, and oncolytic virotherapy, the therapeutic success of which is increasingly linked to a patient’s microbial makeup and immune preparation. Overcoming these challenges through integrative, multidisciplinary inquiry is imperative to unlock the full diagnostic and therapeutic potential of the microbiome in redefining the landscape of breast cancer detection, management and prevention.