{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T10:07:59Z","timestamp":1785146879135,"version":"3.55.0"},"reference-count":54,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:00:00Z","timestamp":1784937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Gynecological malignancies and breast cancer impose substantial health and economic burdens. This review examines how local and systemic microbiota may affect epithelial integrity, inflammation, estrogen metabolism, and immunity. The vaginal ecosystem is the most extensively studied female microbial niche. Cervical cancer serves as the most illustrative clinical example: loss of stable Lactobacillus crispatus dominance and increased prevalence of anaerobic bacteria (anaerobic dysbiosis) are associated with persistent HPV infection, which directly elevates the risk of cervical precancerous lesions. The estrobolome is particularly relevant in endometrial cancer, where intestinal bacterial beta-glucuronidase activity may increase estrogen reabsorption, particularly in obesity and metabolic disease. In ovarian cancer, microbiota is being studied as a possible risk modifier in BRCA1 carriers, but the evidence remains exploratory. In breast cancer, intratumoral bacteria may shape the immune microenvironment, particularly in triple-negative disease. The primary limitation of current research is methodological heterogeneity. Low-biomass samples, such as those from the ovary or endometrium, are highly susceptible to technical contamination. Most studies are cross-sectional and cannot establish causality. Current evidence supports microbiota as a modifier, not a standalone marker or a substitute for standard diagnosis and treatment. Its most plausible near-term role is in multiparameter risk or response models, pending standardized prospective validation.<\/jats:p>","DOI":"10.3390\/ijms27156636","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T09:47:41Z","timestamp":1785145661000},"page":"6636","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Influence of Vaginal, Intestinal, and Tumor Tissue Microbiota on Selected Malignant Tumors in Women"],"prefix":"10.3390","volume":"27","author":[{"given":"Anna","family":"Markowska","sequence":"first","affiliation":[{"name":"Department of Perinatology, Gynecological Obstetric Clinical Hospital, Poznan University of Medical Sciences, Polna 33 Str., 60-535 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hubert","family":"Wolski","sequence":"additional","affiliation":[{"name":"Medical Institute, University of Applied Sciences in Nowy Targ, Kokoszk\u00f3w 71 Str., 34-400 Nowy Targ, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4718-9747","authenticated-orcid":false,"given":"Mateusz","family":"de Mezer","sequence":"additional","affiliation":[{"name":"Department of Immunobiology, Poznan University of Medical Sciences, Rokietnicka 8 Str., 60-806 Poznan, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,25]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global Cancer Statistics 2022: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1038\/s41585-020-0286-z","article-title":"The Microbiome and Gynaecological Cancer Development, Prevention and Therapy","volume":"17","author":"Ilhan","year":"2020","journal-title":"Nat. Rev. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Cocomazzi, G., Del Pup, L., Contu, V., Maggio, G., Parmegiani, L., Ciampaglia, W., De Ruvo, D., Faioli, R., Maglione, A., and Baldini, G.M. (2024). Gynecological Cancers and Microbiota Dynamics: Insights into Pathogenesis and Therapy. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms25042237"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1038\/s41522-024-00577-7","article-title":"Gut and Oral Microbiota in Gynecological Cancers: Interaction, Mechanism, and Therapeutic Value","volume":"10","author":"Wu","year":"2024","journal-title":"npj Biofilms Microbiomes"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1038\/nrc3610","article-title":"The Microbiome and Cancer","volume":"13","author":"Schwabe","year":"2013","journal-title":"Nat. Rev. Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.smim.2017.08.001","article-title":"Microbiota Dysbiosis in Select Human Cancers: Evidence of Association and Causality","volume":"32","author":"Chen","year":"2017","journal-title":"Semin. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4680","DOI":"10.1073\/pnas.1002611107","article-title":"Vaginal Microbiome of Reproductive-Age Women","volume":"108","author":"Ravel","year":"2011","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.tim.2016.11.007","article-title":"Lactobacillus iners: Friend or Foe?","volume":"25","author":"Petrova","year":"2017","journal-title":"Trends Microbiol."},{"key":"ref_9","first-page":"djw029","article-title":"The Intestinal Microbiome and Estrogen Receptor-Positive Female Breast Cancer","volume":"108","author":"Kwa","year":"2016","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2236749","DOI":"10.1080\/19490976.2023.2236749","article-title":"Gut Microbial Beta-Glucuronidase: A Vital Regulator in Female Estrogen Metabolism","volume":"15","author":"Hu","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13073-016-0368-y","article-title":"Potential Contribution of the Uterine Microbiome in the Development of Endometrial Cancer","volume":"8","author":"Chen","year":"2016","journal-title":"Genome Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Sobstyl, M., Brecht, P., Sobstyl, A., Mertowska, P., and Grywalska, E. (2022). The Role of Microbiota in the Immunopathogenesis of Endometrial Cancer. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23105756"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1126\/science.aay9189","article-title":"The Human Tumor Microbiome Is Composed of Tumor Type-Specific Intracellular Bacteria","volume":"368","author":"Nejman","year":"2020","journal-title":"Science"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"eabc4552","DOI":"10.1126\/science.abc4552","article-title":"The Microbiome and Human Cancer","volume":"371","author":"Zitvogel","year":"2021","journal-title":"Science"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1038\/s41392-022-01304-4","article-title":"Intratumoral Microbiota: Roles in Cancer Initiation, Development and Therapeutic Efficacy","volume":"8","author":"Yang","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wen, Q., Wang, S., Min, Y., Liu, X., Fang, J., Lang, J., and Chen, M. (2025). Associations of the Gut, Cervical, and Vaginal Microbiota with Cervical Cancer: A Systematic Review and Meta-Analysis. BMC Womens Health, 25.","DOI":"10.1186\/s12905-025-03599-1"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s40168-016-0203-0","article-title":"The Vaginal Microbiota, Human Papillomavirus Infection and Cervical Intraepithelial Neoplasia: What Do We Know and Where Are We Going Next?","volume":"4","author":"Mitra","year":"2016","journal-title":"Microbiome"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1158\/1940-6207.CAPR-15-0350","article-title":"Cervical Microbiota Associated with Higher Grade Cervical Intraepithelial Neoplasia in Women Infected with High-Risk Human Papillomaviruses","volume":"9","author":"Piyathilake","year":"2016","journal-title":"Cancer Prev. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Usyk, M., Zolnik, C.P., Castle, P.E., Porras, C., Herrero, R., Gradissimo, A., Gonzalez, P., Safaeian, M., Schiffman, M., and Burk, R.D. (2020). Cervicovaginal Microbiome and Natural History of HPV in a Longitudinal Study. PLoS Pathog., 16.","DOI":"10.1371\/journal.ppat.1008376"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ajog.2018.12.011","article-title":"Vaginal Dysbiosis and the Risk of Human Papillomavirus and Cervical Cancer: Systematic Review and Meta-Analysis","volume":"221","author":"Brusselaers","year":"2019","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S0140-6736(18)32470-X","article-title":"Cervical Cancer","volume":"393","author":"Cohen","year":"2019","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1001\/jama.2023.13174","article-title":"Cervical Cancer Screening: A Review","volume":"330","author":"Perkins","year":"2023","journal-title":"JAMA"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Guo, H. (2024). Interactions between the Tumor Microbiota and Breast Cancer. Front. Cell. Infect. Microbiol., 14.","DOI":"10.3389\/fcimb.2024.1499203"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e010365","DOI":"10.1136\/jitc-2024-010365","article-title":"Intratumoral Microbiota Predicts the Response to Neoadjuvant Chemoimmunotherapy in Triple-Negative Breast Cancer","volume":"13","author":"Chen","year":"2025","journal-title":"J. Immunother. Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1126\/science.aah5043","article-title":"Potential Role of Intratumor Bacteria in Mediating Tumor Resistance to the Chemotherapeutic Drug Gemcitabine","volume":"357","author":"Geller","year":"2017","journal-title":"Science"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"\u0141atkiewicz, T., Rasoul-Peli\u0144ska, K., Ku\u0142ak, K., Tarkowski, R., Ku\u0142ak, A., and Puzio, I. (2025). Gynecological Cancer Oncobiome Systematic Review. Cancers, 17.","DOI":"10.3390\/cancers17193227"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cascardi, E., Cazzato, G., Daniele, A., Silvestris, E., Cormio, G., Di Vagno, G., Malvasi, A., Loizzi, V., Scacco, S., and Pinto, V. (2022). Association between Cervical Microbiota and HPV: Could This Be the Key to Complete Cervical Cancer Eradication?. Biology, 11.","DOI":"10.3390\/biology11081114"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"11446","DOI":"10.18632\/aging.206032","article-title":"Effectiveness of Vaginal Probiotics Lactobacillus crispatus Chen-01 in Women with High-Risk HPV Infection: A Prospective Controlled Pilot Study","volume":"16","author":"Liu","year":"2024","journal-title":"Aging"},{"key":"ref_29","first-page":"e85880","article-title":"Role of Vaginal and Gut Microbiota in Human Papillomavirus (HPV) Progression and Cervical Cancer: A Systematic Review of Microbial Diversity and Probiotic Interventions","volume":"17","author":"Pai","year":"2025","journal-title":"Cureus"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e0068325","DOI":"10.1128\/msystems.00683-25","article-title":"Lactobacillus crispatus-Derived nCEV Vesicles Promote Cutaneous Wound Healing and Inhibit HPV16 Infection","volume":"10","author":"Peng","year":"2025","journal-title":"mSystems"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1016\/j.ygyno.2021.03.025","article-title":"Age-Related Distribution of Uncommon HPV Genotypes in Cervical Intraepithelial Neoplasia Grade 3","volume":"161","author":"Giannella","year":"2021","journal-title":"Gynecol. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Przybylski, M., Pruski, D., Wszo\u0142ek, K., de Mezer, M., \u017burawski, J., Jach, R., and Millert-Kali\u0144ska, S. (2023). Prevalence of HPV and Assessing Type-Specific HPV Testing in Cervical High-Grade Squamous Intraepithelial Lesions in Poland. Pathogens, 12.","DOI":"10.3390\/pathogens12020350"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Zhang, B., Mohd Sahardi, N.F.N., Di, W., Long, X., and Shafiee, M.N. (2025). The Gut-Endometrium Axis: Exploring the Role of Microbiome in the Pathogenesis and Treatment of Endometrial Cancer-A Narrative Review. Cancers, 17.","DOI":"10.3390\/cancers17061044"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2451766","DOI":"10.1080\/07853890.2025.2451766","article-title":"Gut Microbiota and Endometrial Cancer: Research Progress on the Pathogenesis and Application","volume":"57","author":"Zheng","year":"2025","journal-title":"Ann. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1126\/science.aan3706","article-title":"Gut Microbiome Influences Efficacy of PD-1-Based Immunotherapy against Epithelial Tumors","volume":"359","author":"Routy","year":"2018","journal-title":"Science"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1126\/science.aan4236","article-title":"Gut Microbiome Modulates Response to Anti-PD-1 Immunotherapy in Melanoma Patients","volume":"359","author":"Gopalakrishnan","year":"2018","journal-title":"Science"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1126\/science.abf3363","article-title":"Fecal Microbiota Transplant Overcomes Resistance to Anti-PD-1 Therapy in Melanoma Patients","volume":"371","author":"Davar","year":"2021","journal-title":"Science"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1126\/science.abb5920","article-title":"Fecal Microbiota Transplant Promotes Response in Immunotherapy-Refractory Melanoma Patients","volume":"371","author":"Baruch","year":"2021","journal-title":"Science"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1038\/s41423-025-01326-2","article-title":"The Gut Microbiota in Cancer Immunity and Immunotherapy","volume":"22","author":"Xie","year":"2025","journal-title":"Cell. Mol. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1038\/s41579-025-01268-6","article-title":"Harnessing the Microbiome for Cancer Therapy","volume":"24","author":"Hajjar","year":"2026","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1097\/IGC.0000000000000999","article-title":"Systematic Review: The Impact of Cancer Treatment on the Gut and Vaginal Microbiome in Women with a Gynecological Malignancy","volume":"27","author":"Muls","year":"2017","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1016\/S1470-2045(19)30340-7","article-title":"Association between the Cervicovaginal Microbiome, BRCA1 Mutation Status, and Risk of Ovarian Cancer: A Case-Control Study","volume":"20","author":"Reisel","year":"2019","journal-title":"Lancet Oncol."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Zhao, X., Liu, Z., and Chen, T. (2023). Potential Role of Vaginal Microbiota in Ovarian Cancer Carcinogenesis, Progression and Treatment. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15030948"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2221093","DOI":"10.1080\/19490976.2023.2221093","article-title":"Gut Microbiota Dysbiosis Promotes the Development of Epithelial Ovarian Cancer via Regulating Hedgehog Signaling Pathway","volume":"15","author":"Hu","year":"2023","journal-title":"Gut Microbes"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s10020-021-00295-2","article-title":"The Role of the Microbiome in Ovarian Cancer: Mechanistic Insights into Oncobiosis and to Bacterial Metabolite Signaling","volume":"27","author":"Sipos","year":"2021","journal-title":"Mol. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.2174\/1871530322666220509034847","article-title":"Microbiome and Development of Ovarian Cancer","volume":"22","author":"Dhingra","year":"2022","journal-title":"Endocr. Metab. Immune Disord. Drug Targets"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1111\/imm.70112","article-title":"Vaginal Microbiota and Ovarian Cancer: A New Frontier in Immunomodulation and Diagnosis","volume":"178","author":"Babay","year":"2026","journal-title":"Immunology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"5039","DOI":"10.1128\/AEM.01235-16","article-title":"The Microbiota of Breast Tissue and Its Association with Breast Cancer","volume":"82","author":"Urbaniak","year":"2016","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"105035","DOI":"10.1016\/j.critrevonc.2025.105035","article-title":"Intratumoral Microbiome in Breast Cancer: A Hidden Player in Tumor Development, Progression and Treatment Response","volume":"217","author":"Canzian","year":"2026","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"101264","DOI":"10.1016\/j.currproblcancer.2025.101264","article-title":"Unraveling the Microbiome\u2019s Role in Breast Cancer Progression and Treatment Response","volume":"60","author":"Taki","year":"2026","journal-title":"Curr. Probl. Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"107726","DOI":"10.1016\/j.phrs.2025.107726","article-title":"Gut Microbiota Reshapes the TNBC Immune Microenvironment: Emerging Immunotherapeutic Strategies","volume":"215","author":"Huang","year":"2025","journal-title":"Pharmacol. Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s13148-025-02046-0","article-title":"Targeting Microbiome-Driven Epigenetic Modifications: A New Frontier in Breast Cancer Treatment","volume":"18","author":"Bai","year":"2026","journal-title":"Clin. Epigenet."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"149872","DOI":"10.1016\/j.gene.2025.149872","article-title":"Vitamin D Regulation of Gut Microbiota-Derived Butyrate as a Potential Inhibitor of Breast Cancer Proliferation","volume":"976","author":"Gong","year":"2026","journal-title":"Gene"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.nutres.2024.01.012","article-title":"Molecular Crosstalk between Polyphenols and Gut Microbiota in Cancer Prevention","volume":"124","author":"Zeb","year":"2024","journal-title":"Nutr. 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