Association Between Gut Microbiota Composition and Emotional Distress in Breast Cancer Patients Pre- and Post-Surgery
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Background Breast cancer affects millions globally, often leading to significant mental health challenges like depressive symptoms and anxiety (emotional distress). In breast cancer patients, the microbiota-gut-brain axis' effect on various psychosocial states is unclear. Methods A prospective, observational clinical study was conducted at Jiangsu University Affiliated People's Hospital, recruiting breast cancer surgery candidates between March 10 and May 25, 2024. Participants provided informed consent and were assessed for demographic characteristics, Clinicopathological data, anxiety and depressive symptoms (emotional distress) using validated questionnaires (GAD-7 and PHQ-9). Preoperative and postoperative fecal samples were collected, processed and sequenced to analyze gut microbiota composition. Results The study included 20 breast cancer patients (average age 53.5 ± 5.7 years). Post-surgery, anxiety and depressive symptoms significantly increased, with moderate to severe anxiety rising from 10–80% and depressive symptoms from 5–70%. Higher education, palpable lumps, specific molecular subtypes, lymph node metastasis, and larger lump sizes were associated with increased depressive symptoms. Significant differences in gut microbiota beta diversity were observed between pre- and post-surgery, correlating with depressive symptoms. Seven genera showed significant abundance changes post-surgery, including decreases in Akkermansia and increases in Ligilactobacillus . Conclusion This study highlights the complex interplay between gut microbiota composition and depressive symptoms in breast cancer patients undergoing surgery. The findings emphasize the need to address mental health in cancer care and suggest a potential role for the gut microbiota in influencing emotional well-being. Further research could lead to personalized interventions targeting the gut-brain axis to improve outcomes for these patients.
