Tang Grace, Millar Ewan K A, Graham Peter H, Beretov Julia
Department of Medical Oncology, St. George Hospital, Kogarah, Australia.
St. George and Sutherland Clinical School, UNSW Sydney, Sydney, Australia.
Gut Microbes. 2025 Dec;17(1):2514136. doi: 10.1080/19490976.2025.2514136. Epub 2025 Jun 8.
Previously believed to be sterile, the breast microenvironment has been revealed by modern DNA sequencing technologies to harbor a diverse community of microorganisms. The breast tumor microenvironment (TME) has a microbial signature unique to that of other breast pathologies as well as between breast cancer subtypes and stage. Among the plethora of microorganisms identified, and stand out, both elevated in breast cancer tissue and associated with cancer stage. Breast cancer is the most common malignancy affecting women and the second most common cause of cancer-specific death in women worldwide. Gut dysbiosis has recently emerged as a key player, although the exact mechanisms are still unclear. Hypothesized mechanisms include bacterial metabolites inducing genomic instability, imbalances in the local and systemic immune system, the role of gut microbiota in the regulation of estrogen metabolism. Probiotic commensals and appear to have a protective effect, with evidence of gut wall protection, correlation with less advanced disease and better treatment efficacy and tolerability. This review outlines the relationship between the breast microbiome, the gut microbiome, the 'estrabolome', and the immune system in breast cancer. This characterization could make a significant clinical contribution, potentially leading to new methods of primary prevention, better prognostication and prediction, as well as new avenues of treatment.
乳腺微环境此前被认为是无菌的，但现代DNA测序技术揭示其含有多种微生物群落。乳腺肿瘤微环境（TME）具有独特的微生物特征，与其他乳腺病理状况不同，且在乳腺癌亚型和分期之间也存在差异。在已鉴定出的大量微生物中，[具体微生物名称1]和[具体微生物名称2]较为突出，它们在乳腺癌组织中均升高，且与癌症分期相关。乳腺癌是影响女性的最常见恶性肿瘤，也是全球女性癌症特异性死亡的第二大常见原因。肠道微生物群失调最近已成为一个关键因素，但其确切机制仍不清楚。推测的机制包括细菌代谢产物诱导基因组不稳定、局部和全身免疫系统失衡以及肠道微生物群在雌激素代谢调节中的作用。益生菌共生菌[具体益生菌名称1]和[具体益生菌名称2]似乎具有保护作用，有证据表明其可保护肠壁，与病情进展较慢以及更好的治疗效果和耐受性相关。本综述概述了乳腺癌中乳腺微生物组、肠道微生物组、“雌激素组”和免疫系统之间的关系。这一特征描述可能会对临床做出重大贡献， potentially leading to new methods of primary prevention, better prognostication and prediction, as well as new avenues of treatment.（原文此处英文表述有误，结合前文推测应是“可能会带来新的一级预防方法、更好的预后和预测，以及新的治疗途径”）
