Fermentation and Breast cancer
Cancer is a major concern and leading cause of death worldwide with the total number of cases is increasing; A recent analysis estimated 13.2 million deaths and 20.3 million incident cases for cancer in 2030. Preventative strategies include eating a healthy diet with many fruits and vegetables. Additionally, there is also evidence that a diet rich in fermented foods such as fermented milk products may have benefit in reducing cancers. For example, kefir,
A type of fermented milk that contains yeast and bacteria not only provide benefit for the digestive tract, but for lowering cholesterol. Its anticancer properties have been linked to the presence of bioactive components including peptides, polysaccharides, and sphingolipids. These compounds are involved in several types of signaling pathways and regulate cell proliferation, apoptosis, and transformation. Kefir includes Lactococcus which is also present in mammary glands to enhance cellular immunity and activate natural killer cells to control tumor growth.
Specifically in breast cancer, a study that examined the effects of kefir on breast cancer cells showed a statistically significant dose dependent suppressive effect on malignant cell proliferation with no inhibitory effect on normal cells. Four kefir products were used in this study (K1-K4). K1 was milk incubated with kefir grains. K2 was K1 that was then fermented for 24 hours. To prepare K3, K2 was added to pasteurized milk. Finally, fermenting K3 for 24 hours created K4. A pasteurized milk sample and 4 different extracts was used for comparison. After 6 days of cell culture, K4 showed the statistically significant effect mentioned previously.
In conclusion, adding fermented foods/ probiotics that contain Lactococcus can be beneficial for women with breast cancer in aiding in anti-inflammatory and other cell regulation.
Rafie N, Golpour Hamedani S, Ghiasvand R, Miraghajani M. Kefir and Cancer: A Systematic Review of Literatures. Arch Iran Med. 2015 Dec;18(12):852-7. PMID: 26621019.
Probiotics and fermented foods are speculated to reduce a woman’s risk in developing breast cancer. This is because breast tissue has many bacteria living within it. This environment heavily changes once a patient develops breast cancer. Probiotics have been proven to improve gut health so the rationale is that these foods can help other areas of the body since having a normal microbiota is very important to maintain overall good health. When developed, breast cancer increases bacteria that are able to cause DNA damage, promoting the proliferation of damaged cells and potentially causing a worsening of the cancer. Escherichia coli and Staphylococcus epidermidis were found in higher abundances in women with breast cancer. These two types of bacteria isolated from breast cancer patients displayed the ability to induce DNA double stranded breaks (DSB) in HeLa cells using the γH2AX assay. The good bacteria are essential to the body in order to fight any bad bacteria that can increase one’s risk of infection, or in this case, development of breast cancer. Changes in these healthy bacteria has been shown to increase cancer risk and the emergence of harmful bacteria has been shown to increase cancer development. This thinking is the reason why it is thought that probiotics and fermented products decrease breast cancer risk. Probiotics and fermented products containing lactic acid bacteria are thought to decrease risk because the bacteria Lactococcus found in the mammary glands is known to enhance immunity through activation of natural killer (NK) cells. Patients with breast cancer are known to have decrease in these natural killer (NK) cells, that play a very important role in the control of the proliferation and the elimination of potential threats to the body. The use of probiotics is also studied to have overall anti-inflammatory effects on the body. Cancer is known as uncontrolled proliferation as an immune response from the body because of a certain trigger event. The body’s immune response is involved in inflammation as a signal to lead specific cells to that area and repeated inflammation can cause an increased risk of cancer in that area, like in certain inflammatory bowel disease like Ulcerative Colitis or Crohn’s disease. Use of probiotics are thought to inhibit the growth of potentially cancerous cells within the breast tissue. There are many benefits to lacto fermentation besides the fermentation stopping bacteria from proliferating in certain areas of the body. This includes acting as a preservative, increasing vitamin and enzyme levels, improving digestibility, controlling yeast overgrowth, balancing of gut flora, causing nutrient absorption, boosting the immune system, rebuilding tissue and alkalizing the body therefore reducing overall gut acidity. Some foods that are fermented that should be recommended are kefir, kombucha, yogurt, sauerkraut, pickles, miso, kimchi and tempeh. Since fermented food is already predigested, as we digest it the microbes go directly into the gut and break up proteins, thus helping break down foods we ate previously or will eat later on. Fermented foods aid the digestive system to do its job more efficiently. Although further studies need to be conducted in order to prove the benefits of probiotics and fermented foods on reducing risk of breast cancer, there are many other pros that a patient can benefit from.
Written by: Denise Cotter and Niyati Doshi
The focus of this presentation was on the basis that probiotics or fermented foods can reduce the risk of women developing breast cancer. It is said that fermented milk products are health promoting because they already contain lactic acid bacteria. The two main bacteria that show these properties are Lactococcus and Streptococcus. Lactococcus lactis is found in the mammary glands and enhances the cellular immunity of natural killer (NK) cells. Streptococcus acts by protecting against DNA damage that can be caused by reactive oxygen species. Fermented foods that are good for you include kefir, kombucha, yogurt, sauerkraut, pickles, miso, kimchi, and tempeh. All these products contain probiotics that can not only be good for the gut, but in females be potentially helpful in reducing the risk of breast cancer. Kombucha has been popular in recent years, especially as it helps improve digestion, increases energy, helps in detoxing the body, and supports the immune system. Products like kombucha have become more popular especially when someone decides to go on a health kick and try to cleanse themselves and their body. Aside from probiotics being beneficial to the reduced risk of breast cancer, soy based products such as soy isoflavones are also seen to reduce the risk of this cancer development. Studies showed that consuming a beverage with L. casei Shirota and soy isoflavone showed a reduced risk of breast cancer development in Japanese women, but only in those who regularly consumed this since childhood.
The idea behind probiotics or fermented food reducing the risk for breast cancer in women is because these products contain lactic acid bacteria (LAB). Lactic acid bacteria is present in everyday diets and in the gastrointestinal tract and urogenital tract. Probiotics are considered live microorganisms, and when given in adequate quantities, it is beneficial to the consumer, especially health wise. Products containing lactic acid bacteria or fermented products have recently gained an increased interest because many studies are being conducted in the added benefits of these products in your daily diet. Consumption of foods or following a certain diet has added benefits in reduced risk of breast cancer because these different foods contain vitamins and healthy fats and probiotics which are beneficial for your body and its regulation. Other factors that add to a risk of cancer that are behavior-related and diet related are high body mass index, low fruit and vegetable intake, lack of physical activity, tobacco use, and alcohol use. A balance of fatty acids that are similarly found in the Mediterranean diet, consuming fruits and vegetables, intake of dietary fiber, and vitamin supplementation along with probiotic consumption are the most studied at the moment and do show that consumption of these food types do lead to decreased risk of breast cancer or tumor development, as they also contain important factors for regulation of your body and diet and contain necessary vitamins.
Aragón, Felix, et al. “Modification in the Diet Can Induce Beneficial Effects against Breast Cancer.” World Journal of Clinical Oncology, Baishideng Publishing Group Inc, 10 Aug. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4127615/#:~:text=The%20consumption%20of%20probiotics%20and,risk%20in%20some%20epidemiological%20studies.
Breast cancer is a major cause of death in women and there have been exhaustive studies into its prevention, diagnosis, and treatment. We’ve been able to determine there are both environmental and genetic factors involved in its formation. Genetic factors are impossible to change so emphasis is put on early detection and screening in women 40 years and older. However, environmental factors, such as tobacco and alcohol use, radiation exposure, lack of physical activity, and especially poor nutrition, are easily identifiable and modified. Poor nutrition and subsequent obesity play a significant role in the progression of breast cancer. Some studies show that the inclusion of fermented products that contain lactic acid bacteria (LAB) may prove beneficial in the early stages of some types of cancer.
Women with breast cancer have a different microbial environment than women without breast cancer. This isn’t an uncommon pattern in cancers - different bacterial profiles exist between the tissue samples of healthy and colorectal cancers and oral squamous cell carcinomas. Tissues taken from breast cancer contain higher quantities of Bacillus, Enterobacteriaceae, and Staphylococcus, which have been shown to directly cause DNA double-stranded breaks, as well as a decreased LAB concentration. The repairing mechanism for double-stranded breaks is especially fallible to mistakes and the continuous buildup of mismatched bases will theoretically lead to genetic mutations, and eventually cancer. Healthy women also have higher concentrations of Lactococcus and Streptococcus than in breast cancer patients. These two strains are known to have anticarcinogenic properties by boosting natural killer (NK) activity, which is responsible for managing the formation of cancerous cells.
Lactic acid bacteria exists in our normal diet as cultured dairy products and vegetables. They also exist endogenously in our gastrointestinal tract and are considered probiotics, with anti-tumor and anti-microbial properties, which are beneficial for our health.A clear relationship between regular inclusion of fermented products and LAB in the diet and the risk reduction of breast, liver, and colon cancer has already been established.
A new study has also shown an association between the consumption of soy-based products, especially soy isoflavones, and the subsequent risk reduction of breast cancer in Japanese women. It is thought that isoflavones act as possible selective estrogen receptor modulators (SERMs) and bind to the estrogen receptor in order to inhibit the proliferative actions of estrogen in the breast tissue. In-vitro studies in animal populations have also shown that LAB may also modulate the host’s immune response, preventing or decreasing tumor growth.
(PDF) Cancer-preventing attributes of probiotics: An update. ResearchGate. https://www.researchgate.net/publication/41620317_Cancer-preventing_attributes_of_probiotics_An_update. Accessed June 24, 2020.
Aragón F, Perdigón G, de Moreno de LeBlanc A. Modification in the diet can induce beneficial effects against breast cancer. World journal of clinical oncology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127615/. Published August 10, 2014. Accessed June 24, 2020.
Urbaniak C, Gloor GB, Brackstone M, Scott L, Tangney M, Reid G. The Microbiota of Breast Tissue and Its Association with Breast Cancer. Applied and environmental microbiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4968547/. Published July 29, 2016. Accessed June 24, 2020.
FERMENTATION, BREAST FEEDING AND BREAST CANCER
The idea of using fermented products to help prevent a diagnosis of breast cancer came along after analyzing different bacterial profiles in breast tissue of women with and without breast cancer. Because of the high prevalence of breast cancer [1 in every 8 women], prevention becomes essential for high risk patients. The human’s microbiota is a collection of “good” bacteria that colonize in certain sites including breast tissue. The composition of these colonies is very important to the human body since any imbalance can create a void for opportunistic bacteria to come in and cause disease. In a 2016 study from the American Center of Microbiology, results showed that healthy women had higher prevalence of Lactococcus, Streptococcus, Corynebacterium, and Micrococcus. Meanwhile, breast cancer patients had higher prevalence of E. coli colonies, S. epidermidis, B. cereus, and Bacteroidetes. Tissue from different kinds and tumor stages were not significantly different. Colonies of E. coli and S. epidermidis were also found to have the ability to cause DNA double stranded breaks. Although highly unstable, these breaks cannot induce cancers on their own but they do make patients more susceptible to further mutations and damage. Furthermore, B. cereus was found to increase levels of 5-alpha-pregnane-3,20-dione, which is a progesterone metabolite with a carcinogenic effect causing uncontrolled proliferation and detachment of cells. On the other hand, bacteria coming from fermented milk and other products exhibit anti-carcinogenic properties like enhancing cellular immunity to control cell proliferation and therefore tumor growth. These species of bacteria include strains of Lactococcus and Streptococcus especially L. lactis and S. thermophilus. Therefore, this study gives merit to the idea that fermented products and a healthy microbiota can help prevent breast cancer diagnoses especially in high risk patients. Examples of fermented products that can be included in a healthy diet include Kefir milk, Kombucha, Kimchi, pickles, and Tempeh. In conclusion, more studies are needed in order to prove the benefits of fermented products in preventing cancers. However, as pharmacists, we always advice patients to have healthy well balanced diets, which include fermented food and probiotics, not only to prevent cancers but also to increase their energy and maintain a healthy weight.
Urban, Joanna. "Beneficial Bacteria May Protect Breasts From Cancer." Beneficial Bacteria May Protect Breasts From Cancer. American Society for Microbiology. N.p., June 2016. <https://www.asm.org/index.php/journal-press-releases/94283-beneficial-bacteria-may-protect-breasts-from-cancer>
This presentation focused on fermented foods and the benefits of that in prevention of Breast cancer. Fermented foods are predigested. Once we eat the microbes go out into the gut and break up the proteins and help break down the food we are consuming. This makes it easier for the digestive system to work and break down food. Fermented foods when consumed are acidic, but they get alkalized inside the gut and regulate the pH. Breast cancer is one of the most common cancers a woman can get. It is known that women who drink fermented milk products have a reduced risk of cancer. This is because of the health promoting properties present in lactic acid bacteria. There are two bacterias that exhibit non-cancerous properties: Lactococcus and Streptococcus. Lactococcus is present in mammary glands and they enhance the cellular immunity by activating the natural killers cells which are known to control tumor growth. A low number of NK cells is linked to a higher number of patients with breast cancer. Streptococcus prevents DNA damage caused by ROS.
These are present more in healthy women as compared to women with breast cancer. Therefore addition of fermented foods/ probiotics that contain these bacterias can be beneficial for women with breast cancer. Some research has shown that the use of probiotics can produce an anti-inflammatory effect, which can inhibit the growth of cancerous cells in the breast. Some examples of probiotics are low-fat, plain organic yogurt with live or active cultures, kefir (a yogurt-like drink), kombucha tea, fermented vegetables like sauerkraut and kimchi, fermented soybeans (miso). It is recommended to have one serving of probiotics everyday for patients to have some benefit.
Cordeiro B, MD Anderson Cancer Center. Probiotics: Healthy bacteria for your gut. MD Anderson Cancer Center. https://www.mdanderson.org/publications/focused-on-health/FOH-probiotics.h14-1589835.html. Published May 4, 2015. Accessed May 27, 2020.
There are questions about whether probiotics and fermented foods can reduce a woman’s risk for breast cancer. Breast tissue contains a diverse bacterial profile that differs between that of healthy women and women with breast cancer. Normal microbiota is important in the human body, and changes in microbiota composition may promote the development of disease. Breast cancer patients experience an increase in bacteria that are able to cause DNA damage, and a decrease in some lactic acid bacteria. Escherichia coli and Staphylococcus epidermidis are two strains of bacteria that have been isolated from breast cancer patients, which are capable of causing DNA double-stranded breaks. Women who are at higher risk for breast cancer are more susceptible to bacteria-induced DNA damage. Bacteria may also increase breast cancer risk through other mechanisms; Bacillus cereus can increase levels of a progesterone metabolite that stimulates cell proliferation and detachment.
Overall the microbiota, or “good bacteria” in the body is essential for promoting a stronger immune system to fight infection. Changes in microbiota composition has been linked to cancer risk. More specifically, studies have shown an increase in pathogenic bacteria that promotes cancer development through various mechanisms. On the other hand, studies have also shown that consuming probiotics and fermented products containing lactic acid bacteria can possibly reduce breast cancer risk. Fermentation is the process by which bacteria breaks down the sugar and starch in food to produce lactic acid and CO2. Fermented foods support the immune system and digestion, and include yogurt, kefir, kombucha, and cultures vegetables.
Although data is still limited, and further studies are still need before we can really know the role of probiotics and fermented foods in preventing breast cancer. Present evidence does show a link, and women may benefit from increasing these products in their diet as another tool for cancer prevention.
Breast Cancer and Probiotic Link Largely Untapped. International Probiotics Association. http://internationalprobiotics.org/4489-2/. Accessed May 27, 2020.