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Although beyond the primary scope of this review, it is worth mentioning that emerging evidence highlights the gut microbiome as a potential mediator of circadian disruption-associated breast carcinogenesis, with studies indicating that NSW can alter microbial composition and diurnal rhythmicity, thereby modulating systemic inflammation, estrogen metabolism, and immune function, all of which are relevant to BC risk 260

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This human host must have certain genetic characteristics (HLA or cytochrome P450-CYP gain- or loss-of-function mutations), which lead to a specific type of immune response capable of generating the clinical response of DRESS

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