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The Intratumoral Microbiota in Breast Cancer: Roles in Progression, Immunity, and Therapy

Zhihao Wei1,#, Jijie Cai1,#, Sifen Wang2,#, Yachen Li3, Libo Luo1, Jun Chen1, Fuyu Li1, Hongyu Nie1, Ke Gong4,*, Manbo Cai1,*
1 Department of Oncology, the First Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, China
2 State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-Sen University Cancer Center, Guangzhou, China
3 Nanchang University Queen Mary School, Nanchang, China
4 Department of Thyroid and Breast Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde, China
* Corresponding Author: Ke Gong. Email: email; Manbo Cai. Email: email
# These authors contributed equally to this work
(This article belongs to the Special Issue: Advances in Cancer Therapeutics)

Oncology Research https://doi.org/10.32604/or.2026.079281

Received 19 January 2026; Accepted 04 May 2026; Published online 18 May 2026

Abstract

Breast cancer (BC) remains a leading cause of cancer-related mortality worldwide, and accumulating evidence suggests that tumor-associated microbiota may contribute to disease heterogeneity beyond host genetic and immune determinants. Advances in sequencing and multi-omics technologies have uncovered a reproducible intratumoral microbiome in BC, with distinct compositional patterns associated with molecular subtypes, clinicopathological features, and clinical outcomes. Alterations in specific microbial taxa have also been linked to tumor immune status, metastatic potential, and therapeutic sensitivity, underscoring their potential value in disease stratification and prognostic assessment. Although breast tissue represents a low-biomass environment, multiple studies employing stringent contamination control strategies have confirmed the reliability of these microbial signals. Experimental evidence further demonstrates that intratumoral microbes are functionally active components of the tumor microenvironment (TME), influencing tumor progression and metastasis through immune modulation, inflammatory signaling, and metabolic or hormonal reprogramming, while also shaping responses to chemotherapy and immunotherapy. This review summarizes current knowledge on the compositional features, functional mechanisms, and clinical relevance of the BC intratumoral microbiome, highlights methodological challenges in low-biomass profiling, and discusses future directions for translating these findings into clinically actionable strategies. The aim of this review is to systematically evaluate the role of the intratumoral microbiome in breast cancer pathogenesis and treatment, and to propose a framework for translating current findings into clinical practice.

Keywords

Breast cancer (BC); intratumoral microbiota; tumor progression; chemotherapy resistance; immunotherapy

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