Investigation of the Association Between the Fecal Microbiota and Breast Cancer in Postmenopausal Women: a Population-Based Case-Control Pilot Study

We investigated whether the gut microbiota differed in 48 postmenopausal breast cancer case patients, pretreatment, vs 48 control patients. Microbiota profiles in fecal DNA were determined by Illumina sequencing and taxonomy of 16S rRNA genes. Estrogens were quantified in urine. Case-control comparisons employed linear and unconditional logistic regression of microbiota alpha-diversity (PD_whole tree) and UniFrac analysis of beta-diversity, with two-sided statistical tests. Total estrogens correlated with alpha-diversity in control patients (Spearman Rho = 0.37, P =.009) but not case patients (Spearman Rho = 0.04, P =.77). Compared with control patients, case patients had statistically significantly altered microbiota composition (beta-diversity, P =.006) and lower alpha-diversity (P =.004). Adjusted for estrogens and other covariates, odds ratio of cancer was 0.50 (95% confidence interval = 0.30 to 0.85) per alpha-diversity tertile. Differences in specific taxa were not statistically significant when adjusted for multiple comparisons. This pilot study shows that postmenopausal women with breast cancer have altered composition and estrogen-independent low diversity of their gut microbiota. Whether these affect breast cancer risk and prognosis is unknown.