Table of Contents
ISRN Oncology
Volume 2013, Article ID 693920, 10 pages
Review Article

Evolving Concepts: How Diet and the Intestinal Microbiome Act as Modulators of Breast Malignancy

1Monter Cancer Center, Don Monti Division of Oncology and Division of Hematology, Hofstra North Shore Long Island Jewish School of Medicine, 450 Lakeville Road, Lake Success, NY 11042, USA
2Hofstra North Shore Long Island Jewish School of Medicine, Division of Gastroenterology, Hepatology and Nutrition, North Shore University Hospital, 300 Community Drive, Manhasset, NY 11030, USA
3Feinstein Institute for Medical Research, Robert S. Boas Center for Genomics and Human Genetics and Elmezzi Graduate School of Molecular Medicine, Hofstra North Shore Long Island Jewish School of Medicine, 350 Community Drive, Manhasset, NY 11030, USA
4Population Health-Hofstra North Shore-LIJ School of Medicine and North Shore/LIJ Health System, 175 Community Drive, Room 203, Great Neck, NY 11021, USA

Received 30 July 2013; Accepted 25 August 2013

Academic Editors: B. B. Patel and D. Peng

Copyright © 2013 Iuliana Shapira et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The intestinal microbiome plays an important role in human physiology. Next-generation sequencing technologies, knockout and gnotobiotic mouse models, fecal transplant data and epidemiologic studies have accelerated our understanding of microbiome abnormalities seen in immune diseases and malignancies. Dysbiosis is the disturbed microbiome ecology secondary to external pressures such as host diseases, medications, diet and genetic conditions often leading to abnormalities of the host immune system. Specifically dysbiosis has been shown to lower circulating lymphocytes, and increase neutrophil to lymphocyte ratio, a finding which has been associated with a decreased survival in women with breast cancers. Dysbiosis also plays a role in the recycling of estrogens via the entero-hepatic circulation, increasing estrogenic potency in the host, which is another leading cause of breast malignancy. Non-modifiable factors such as age and genetic mutations disrupt the microbiome, but modifiable factors such as diet may also lead to profound disruptions as well. A better understanding of dietary factors and how they disrupt the microbiome may lead to beneficial nutritional interventions for breast cancer patients.