Multitarget mechanisms and clinical integration of traditional Chinese medicine in breast cancer.

BACKGROUND

Breast cancer management is challenged by tumor heterogeneity, drug resistance, and the severe side effects of conventional therapies. Conventional therapeutic strategies are constrained by inherent toxicity, development of drug resistance, and associated complications. In contrast, growing evidence suggests that Traditional Chinese Medicine (TCM) offers a complementary approach, characterized by its multi-targeting capabilities and diverse compounds that include both relatively safe edible herbs and potent bioactive agents.

PURPOSE: This review systematically synthesizes contemporary evidence to elucidate the multi-target mechanisms of TCM against breast cancer, as well as its role in mitigating adverse reactions in combination with chemotherapy, radiotherapy, and postoperative complications. This provides a basis for combination drug therapy in the treatment of breast cancer.

METHODS

We searched databases from PubMed, Web of Science and CNKI covering publications from 2012 to 2025. Based on the predefined inclusion criteria, we screened targeted studies from retrieved literature and conducted in-depth analysis and discussion thereon. Article selection was performed according to PRISMA guidelines (Preferred Reporting Items for Systematic reviews and Meta-Analyses).

RESULTS

Bioactive TCM components, such as Wogonin, Resveratrol, and Cryptotanshinone, exert antitumor effects by concurrently modulating key oncogenic pathways (PI3K/Akt, MAPK, Wnt/β-catenin, STAT3, NF-κB), thereby inhibiting proliferation, inducing apoptosis, and suppressing metastasis. Notably, several compounds effectively reverse multidrug resistance by inhibiting ABC transporters (e.g., P-gp, BCRP) via direct interaction or signaling pathway modulation. Clinically, TCM formulations significantly mitigate treatment-induced toxicities, including myelosuppression, gastrointestinal distress, and cardiotoxicity, while improving patients' quality of life and tolerance to anticancer regimens. The concept of Medicinal-Food Homology (MFH) underscores the value of low-toxicity, diet-compatible herbs for long-term supportive care.

CONCLUSIONS

TCM represents a valuable reservoir of multi-target agents that address both the molecular complexity of breast cancer and the practical need to reduce treatment-related morbidity. Elucidating the molecular interactions between TCM components and oncogenic signaling pathways is essential for developing personalized, integrated Chinese-Western therapeutic models that improve patients' immunity, quality of life and tolerance to conventional treatments.