Unraveling the connections between gut microbiota, stress, and quality of life for holistic care in newly diagnosed breast cancer patients

Abstract

There is little research about the stress, quality of life (QOL) and gut microbiota in newly diagnosed breast cancer patients. In this study addressing the dearth of research on stress, quality of life (QOL), and gut microbiota in newly diagnosed breast cancer patients, 82 individuals were prospectively observed. Utilizing the Functional Assessment of Chronic Illness Therapy (FACT)-Breast questionnaire to assess health-related quality of life (HRQOL) and the Distress Thermometer (DT) to gauge distress levels, the findings revealed a mean FACT-B score of 104.5, underscoring HRQOL's varied impact. Significantly, 53.7% reported moderate to severe distress, with a mean DT score of 4.43. Further exploration uncovered compelling links between distress levels, FACT-B domains, and microbial composition. Notably, Alcaligenaceae and Sutterella were more abundant in individuals with higher DT scores at the family and genus levels (p = 0.017), while Streptococcaceae at the family level and Streptococcus at the genus level were prevalent in those with lower DT scores (p = 0.028 and p = 0.023, respectively). This study illuminates the intricate interplay of stress, QOL, and gut microbiota in newly diagnosed breast cancer patients, offering valuable insights for potential interventions of biomarker or probiotics aimed at alleviating stress and enhancing QOL in this patient cohort.

Figure 1

Identified potential bacteria biomarker in DT of breast cancer (Potential bacterial biomarkers in Family and Genus level with LEfSe analysis). Alpha-diversity by Shannon index and inter-quantile distribution indicate the richness and evenness divided with DT score (1a). Top 20 bacteria composition in genus level of each sample by percentage abundance ((1b), left). The most abundant genus of bacteria found in merge sample group were Bacteroides ((1b), right). In family level, Alcaligenaceae is significant in DT score less than 4 (p = 0.017, (1c) left), while Streptococcaceae is associated in DT score over 5 (p = 0.023, (1c) right). Further in genus level, A. Sutterella is a specific biomarker in DT score under 4 (p = 0.017, (1d) left). On the other hand, S. Streptococcus is a specific biomarker in DT score oner 5 (P = 0.023, (1d) right). Detailed LDA score list in Table 4. Using Linear discriminant analysis (LDA) Effect Size (LEfSe) under condition with p < 0.05, Log LDA score > 1.0. We identified some potential biomarker associated with DT score. However, we cannot identify more significant species in LEfSe due to bacteria diversity. (0: represent DT score less than 4; 1: represent DT score over than 5).

Figure 2

Identified potential bacteria biomarker in FACT-B of breast cancer. Alpha-diversity by Shannon index and inter-quantile distribution indicate the richness and evenness divided with FACT-B criteria (2a). Top 20 bacteria composition in genus level for each sample divided by FACT-B ((2b), left). Each label represents the percentage abundance of top 20 taxonomy. The most abundant genus of bacteria found in merged FACT-B group were Bacteroides ((2b), right). Acidaminococcus is a specific bacteria biomarker in FACT-G below average (p = 0.045, (2c)) and FACT-B below average (p = 0.024, (2d)). Detailed LDA score list in Table 5.