Background: Breast cancer remains the most prevalent malignancy among women globally, with conventional therapies incurring significant morbidity. Ayurveda, the classical Indian medical system, offers a conceptually rich understanding of neoplastic disease through the frameworks of Granthi and Arbuda, implicating disordered Dosha dynamics, Dhatu kshaya, and compromised Agni. Rasayana (bio-rejuvenative) therapies and Bhasma (calcined metallic or mineral preparations) represent two distinct but complementary therapeutic traditions within Ayurvedic oncology that have attracted growing scientific scrutiny.

Objective: This review critically synthesises available classical textual evidence and contemporary preclinical and clinical research concerning the role of Rasayana drugs and Bhasma preparations in the management of breast cancer, with the aim of identifying mechanistic pathways, evaluating evidence quality, and delineating future research priorities.

Methods: A systematic narrative review of classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridayam) and contemporary peer-reviewed publications (PubMed, Scopus, AYUSH Research Portal, Google Scholar; 2000–2024) was conducted. Studies involving in vitro cytotoxicity, in vivo animal models, and human clinical trials pertaining to Rasayana drugs and Bhasma in breast cancer or cancer cell lines (primarily MCF-7, MDA-MB-231) were included. Articles from predatory journals, non-peer-reviewed sources, and those lacking methodological transparency were excluded.

Results: Twenty-two Rasayana drugs and six principal Bhasma preparations were identified with documented anti-cancer activity. Key mechanisms include induction of intrinsic and extrinsic apoptotic pathways, inhibition of NF-kB and PI3K/Akt/mTOR signalling, immunomodulation via natural killer cell activation, anti-angiogenic effects mediated through VEGF suppression, and nanoparticle-mediated cytotoxicity from Bhasma. Trivanga Bhasma demonstrated notable cytotoxicity against MCF-7 cells (IC50 data reported). However, the majority of evidence remains preclinical; robust phase I/II clinical trials are critically lacking.

Conclusion: Ayurvedic Rasayana and Bhasma therapies hold evidence-supported promise as integrative oncological interventions. Translation from preclinical promise to clinical validation requires standardised preparation methods, rigorous trial design, and interdisciplinary collaboration. Mechanistic nano-pharmacology of Bhasma offers a particularly compelling frontier for future investigation