Abstract
Background/Objectives: Aromatase inhibitors (AIs)-specifically, letrozole, anastrozole and exemestane-represent the current gold standard for patients with estrogen-receptor-positive breast cancer (ER + BC). This narrative review highlights potential interactions between nutrients and AIs, elucidating their molecular mechanisms involved. Methods: A comprehensive search was conducted across the PubMed, ScienceDirect, Google Scholar, and Scopus databases to identify scientific publications and elucidate recommended dietary regimes for ER + BC patients treated with AIs. Results: Certain bioactive substances found in licorice, rosemary, juniper, cannabis, and citrus fruits exhibit intrinsic aromatase-inhibiting effects. Additionally, other nutrients and compounds-including honey, ginger, turmeric, sweet potatoes, pomegranates, bitter melon, dark sweet cherries, resveratrol, and vitamins D and C-contribute to treatment outcomes through their demonstrated antiproliferative properties. Certain natural compounds, such as soy, cow's milk, sesame seeds, and sesame oil, require caution due to their potential estrogen-like effects which could diminish the anti-estrogenic efficacy of AIs. Conclusions: These considerations hold significant weight in this context, as the management of oncological patients-particularly women with ER + BC-requires an integrated perspective. Antineoplastic treatment must be supported by appropriate nutrition to enhance antitumor efficacy and improve the patient's quality of life. The data presented herein are derived from in vitro, in silico, and animal model studies and await validation in large patient cohorts. Nevertheless, these findings pave the way for future research to elucidate these molecular phenomena in humans and to establish clinically significant conclusions for ER + BC patients.