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INTERNATIONAL CONGRESS OF

CancerGenetics

• Association Between Fluoroquinolone Antibiotic Exposure and Breast Cancer Risk or Progression: A Systematic Review

• Asma Yazdani,¹ Tina Haghi,² Ali Khodadadi,^3,*
  1. Student Research Committee, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, IR Iran.
  2. Student Research Committee, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, IR Iran.
  3. Department of Immunology, School of Medicine, Ahvaz Jondishapur University of Medical Sciences, Ahvaz, Iran
  
  
  
• Introduction: Breast cancer is one of the most common types of cancer among women, and identifying its risk factors and therapeutic strategies is of high importance. Fluoroquinolones are a widely used class of antibiotics that have garnered researchers' attention due to their biological effects, including DNA damage induction and interference with cell division. These drugs can influence cancer cell growth by inhibiting enzymes involved in the replication process; therefore, some fluoroquinolone derivatives have been investigated and used as anti-tumor agents in breast cancer treatment. However, there is also evidence suggesting that antibiotic use might be associated with an increased risk of certain cancers, including breast cancer, although this association has not yet been definitively confirmed. The aim of this study is to systematically review existing research on the impact of fluoroquinolone antibiotic use on the risk and progression of breast cancer.
• Methods: This study was conducted based on the PICO criteria, aligned with the research objective, and in accordance with the PRISMA checklist. In this systematic review, a comprehensive search of articles from 2020 to 2025 was performed in PubMed, SCOPUS, Web Of Science, SID, and Magiran databases, as well as the Google Scholar search engine. Boolean operators and MESH keywords "Progression," "Risk," "Breast Cancer," and "Fluoroquinolone" were used. Subsequently, two independent researchers screened the found articles based on the inclusion criteria. Finally, after reviewing the inclusion and exclusion criteria and critically appraising the quality of selected articles, 7 articles out of 155 initially found were included in the study.
• Results: Studies indicate that long-term antibiotic use is associated with an increased risk of breast cancer. Women who consumed antibiotics for more than one year within a five-year period showed a 15% higher risk of developing breast cancer compared to women who did not use any antibiotics. Furthermore, women who used five or more different types of antibiotics exhibited an 11% increased risk compared to non-users. On the other hand, laboratory investigations on fluoroquinolone derivatives have shown that this class of antibiotics can possess anti-tumor effects in breast cancer by inhibiting the DNA Topoisomerase II enzyme. For example, Gemifloxacin prevents metastasis and cell migration by inhibiting the NF-κB signaling pathway. Additionally, Ciprofloxacin and Norfloxacin, which are newer fluoroquinolone derivatives, have demonstrated stronger anti-tumor properties compared to previous compounds and play roles in cell cycle arrest, apoptosis induction, increased P53 protein expression, and DNA damage. Moxifloxacin also reduces the proliferation and survival of treatment-resistant breast cancer cells by inhibiting the S and G2/M phases of the cell cycle.
• Conclusion: The findings suggest that long-term antibiotic use, particularly at high doses or with a greater diversity of drugs, may be associated with an increased risk of breast cancer. However, the majority of the existing evidence is based on laboratory or preclinical studies, and further research is necessary to confirm this association at the clinical level. In contrast, some fluoroquinolone derivatives have shown anti-tumor properties in preclinical studies, positioning them as potential therapeutic options for breast cancer. To accurately assess the beneficial or harmful effects of these drugs, future interventional studies and clinical trials are essential.
• Keywords: Fluoroquinolone/ Breast Cancer/ Risk/ Progression