Health-related quality of life is associated with fecal microbial composition in breast cancer survivors

Authors: Smith KS, Tissier EA, Bail JR, Morrow CD, Demark-Wahnefried W, Frugé AD

Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2021

Abstract Body:
Purpose: To explore differences in fecal microbial composition between non-obese and obese female breast cancer survivors (BCS) enrolled in a clinical trial and associations between individual microbiota and health-related quality of life (QOL). Methods: A cross-sectional substudy was conducted using samples and data collected at baseline on BCS recruited from 2013-2014 to participate in a randomized controlled trial of a lifestyle intervention in the Birmingham, AL area. Measures included anthropometrics, QOL (Short Form Health-related QOL Survey-36 [SF-36]), and 16S rRNA sequencing of fecal samples. Participants were categorized by body mass index (BMI) into non-obese (≤29.9 kg/m2; n=38) and obese (≥30.0 k/m2; n=32) groups. Differences in bacterial taxa between groups were assessed using Kruskal-Wallis one-way analysis of variance. Spearman and partial correlations explored associations between taxa and SF-36 subscales. Results: Most BCS (72.9%) were non-Hispanic white with average age of 61.6 (±8.7) years. Non-obese BCS had a significantly higher relative abundance of Ruminococcus (p=0.003), Streptococcus (p=0.049), Roseburia (p=0.035), and Dorea (p=0.003), and a lower relative abundance of Pseudomonas (p=0.016) and Proteus (p=0.017). No differences were observed for SF-36 subscales between groups. Overall, Tissierella Soehngenia was negatively correlated with Bodily Pain and Vitality (ρ=-0.287, p=0.026; ρ=-0.302, p=0.02; respectively) and Proteus was positively correlated with Total Physical Health subscale (ρ=0.290, p=0.027). Physical Functioning, Vitality, and Mental Health subscales were negatively associated with Ruminococcus (ρ=-0.304, p=0.036; ρ=-0.361, p=0.012; ρ=-0.495, p<0.001) and Dorea (ρ=-0.318, p=0.028; ρ=-0.33, p=0.022; ρ=-0.388, p=0.006) abundance when controlling for BMI. Conclusions: Fecal microbial composition differed between obese and non-obese BCS, with associations between QOL and several microbial taxa. Several of these genera, previously identified as potentially beneficial, such as Ruminococcus, Roseburia, and Dorea, may also influence QOL in BCS. These results support further analyses to determine the role of individual microbiota in health-related quality of life and obesity in cancer survivors.

Keywords: breast cancer; survivors; gut microbiome; quality of life