Ketogenic diets: Dietary therapeutic potential on breast cancer

Among the various types of tumors, breast cancer (BC) has a high distribution in the world population and is responsible for a high mortality rate. Like other forms of cancer, BC is characterised by distinctive features such as high-energy metabolism in tumor cells, genetic mutations, and mitochondrial dysfunction that sometimes make conventional therapies less effective. However, there is a growing awareness of the vital role played by diet therapy in the overall management of the patient with BC, both by supporting standard therapy and by directly targeting aberrant biological processes involved in carcinogenesis. Among the various nutritional strategies, the ketogenic diet (KD) has recently emerged as a promising therapeutic option for BC. Emerging evidence shows that KD, whether used alone or in combination with standard care, can directly influence tumor cell metabolism and reduces the risk of metastasis, thereby enhancing the efficacy of conventional drug therapies. This may allow for drug dose optimization, leading to fewer side effects and improved patient's quality of life. Nonetheless, the lack of clear evidence on the nutritional protocol to be adopted in BC patients, underlines the need for further research. This review aims to provide an overview of the effects of KD in the management of BC, both as a nutritional treatment and as an adjuvant therapy, providing insights into the implementation of precision nutrition protocols for this and other types of cancer.