Breast cancer microbiota and the gut-breast crosstalk. (a) Different bacterial profile between healthy women and breast cancer patients. (b) Bacterial DNA load is reduced in tumor versus paired normal and healthy breast tissues. (c) Hierarchical clustering of endocrine receptor (estrogen or progesterone receptor) positive (BRER), human EGFR2 (HER2) positive (BRHR), triple positive (estrogen, progesterone, and HER2 receptor positive) (BRTP), and triple negative (absence of estrogen, progesterone, and HER2 receptors) (BRTN) tumors based on their microbial signature. Modified from [35]. (d) Factors and mechanisms by which gut microbes influence breast cancer development and progression. Gut microbes can affect breast physiology by producing specific metabolites that can activate the EMT program or influence the metabolism of estrogens with a potential impact on estrogen receptor-positive tumor subtypes. Panels (a), (b), and (d) have been modified from Servier Medical Art, licensed under a Creative Common Attribution 3.0 Generic License; http://smart.servier.com/.