Exploring the Potential of Breast Microbiota as Biomarker for Breast Cancer and Therapeutic Response

Sabine Dieleman, Romy Aarnoutse, Janine Ziemons, Loes Kooreman, Annemarie Boleij, Marjolein Smidt*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Breast cancer tissue contains its own unique microbiota. Emerging preclinical data indicates that breast microbiota dysbiosis contributes to breast cancer initiation and progression. Furthermore, the breast microbiota may be a promising biomarker for treatment selection and prognosis. Differences in breast microbiota composition have been found between breast cancer subtypes and disease severities that may contribute to immunosuppression, enabling tumor cells to evade immune destruction. Interactions between breast microbiota, gut microbiota, and immune system are proposed, all forming potential targets to increase therapeutic efficacy. In addition, because the gut microbiota affects the host immune system and systemic availability of estrogen and bile acids known to influence tumor biology, gut microbiota modulation could be used to manipulate breast microbiota composition. Identifying breast and gut microbial compositions that respond positively to certain anticancer therapeutics could significantly reduce cancer burden. Additional research is needed to unravel the complexity of breast microbiota functioning and its interactions with the gut and the immune system. In this review, developments in the understanding of breast microbiota and its interaction with the immune system and the gut microbiota are discussed. Furthermore, the biomarker potential of breast microbiota is evaluated in conjunction with possible strategies to target microbiota in order to improve breast cancer treatment.

(Am J Pathol 2021, 191: 968-982; https://doi.org/10.1016/j.ajpath.2021.02.020)

Original languageEnglish
Pages (from-to)968-982
Number of pages15
JournalAmerican Journal of Pathology
Issue number6
Publication statusPublished - Jun 2021




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