Exploring the Potential Therapeutic Role of Manuka Honey in Breast Cancer

Breast cancer is one of the most widespread malignancies in the world, with a complex etiology, tumor heterogeneity, and issues such as therapeutic resistance and treatmentrelated toxicity. Although improved chemotherapy, radiotherapy, endocrine therapy, targeted therapy, and immunotherapy have been developed, limitations in their efficacy, accessibility, and safety still prompt the exploration of complementary therapeutic options. The honey product called Manuka honey (MH) has been popular because of its high content of bioactive compounds, such as methylglyoxal (MGO), flavonoids, and phenolic acids, which are antioxidants, anti-inflammatory agents, and anticancer agents. This literature review summarizes the available preclinical and emerging evidence of the possible role of MH in breast cancer. In vitro experiments indicate that MH induces apoptosis and prevents proliferation of estrogen receptorpositive (ER+ ) breast cancer cells by actions that include Poly (ADP-Ribose) Polymerase (PARP) cleavage, activation of AMP-activated protein kinase (AMPK), and suppression of PI3K/AKT/mTOR and STAT3. In vivo results also indicate that MH can inhibit tumor growth and boost the efficacy of traditional therapies like tamoxifen. Also, its polyphenolic compounds play a role in the regulation of oxidative stress, cytokines, and anti-angiogenic properties. Even though these results demonstrated the potential of MH as a complementary therapeutic agent and its good safety profile, existing data is mainly preclinical in nature. The main issues include the necessity of standardized formulations (e.g., UMF/MGO grading), extensive pharmacokinetic analysis, and effective clinical trials in order to prove efficacy and safety in the human population. Conclusively, MH is a promising multi-target adjunctive in treating breast cancer, especially the ER+ subtypes, which should be explored using well-designed clinical trials.