Abstract

Despite tremendous advances in medicine over the past few decades and significantly improved understanding of the symptomology and contributors to breast cancer (BC) incidence, BC rates continue to rise worldwide, with BC being a leading cause of cancer-related death among women. To reduce BC incidence, it is necessary to focus on promoting prevention strategies through a population-based approach of lowering exposure to modifiable risk factors in addition to the application of newer drug interventions (chemoprevention) for prevention in high-risk populations. Currently, available data suggest that lifestyle modifications through a healthy diet and increased physical activity (PA) play a crucial role in BC prevention; specifically, there is growing evidence to indicate that the Mediterranean diet (MeD) lowers cancer risk. This review summarizes the potential role of the MeD and PA in reducing BC risk, with an additional focus on microbial modulation in BC prevention, based on the current evidence obtained from PubMed. After reviewing the immunomodulatory and anticarcinogenic effects of both the MeD and PA, we conclude that further evaluation and proper implementation of both interventions can significantly reduce the risk of BC and associated mortality in the general population.

Highlights

  • BackgroundThe incidence rate of breast cancer (BC) has been steadily rising by 0.5% each year, and the five-year survival rate for women diagnosed with BC is approximately 90% [1]

  • Available data suggest that lifestyle modifications through a healthy diet and increased physical activity (PA) play a crucial role in BC prevention; there is growing evidence to indicate that the Mediterranean diet (MeD) lowers cancer risk

  • This review summarizes the potential role of the MeD and PA in reducing BC risk, with an additional focus on microbial modulation in BC prevention, based on the current evidence obtained from PubMed

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Summary

Introduction

The incidence rate of breast cancer (BC) has been steadily rising by 0.5% each year, and the five-year survival rate for women diagnosed with BC is approximately 90% [1]. Several studies have demonstrated that a Mediterranean-style diet beneficially modulates the gut microbiome in both humans and experimental animal models, with evidence of increased microbial diversity, higher levels of total SCFAs (such as butyrate, propionate, and acetate) and secondary bile acids [3,60], and increased bacterial-processed bioactive compounds, such as polyphenols (in mammary tissue), that have anticancer properties [61,62] (Figure 1). The use of Lactobacillus as a probiotic has been associated with reduced tumor growth, invasion, and metastasis in mouse models, indicating that Lactobacillus is a negative regulator of BC [3] These data suggest that the MeD can significantly influence the microbial population in the gut and mammary tissue, such that microbial modulation through diet can be a promising target in BC prevention and treatment. Th1 cytokine production, CD4+ T cell proliferation Myeloid-derived suppressor cells, regulatory T-cells (Tregs)

Conclusions
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