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Introduction: Interventions which improve the body composition and metabolic health of women with breast cancer are essential because they can improve the prognosis of this disease. Ketogenic diets have been suggested as complementary nutritional treatments for cancer patients. This systematic review was conducted with aim to determine the effect of ketogenic diets on the therapeutic and metabolic outcomes of breast cancer. Methods: In this systematic review, in order to find the related articles, Medline, Embase, Google Scholar, ScienceDirect, Magiran, SID, ISC, and Cochrane databases were searched with the keywords of low carbohydrate, carbohydrate restriction, Ketogenic diet, breast cancer, breast tumor, and breast neoplasms in English and Persian languages until November 2022. Results: Five studies were reviewed. The results showed that breast cancer patients following a ketogenic diet had significant improvements in emotional and social functions, reduced disease symptoms, and improved metabolic health biomarkers (creatinine, triglycerides, insulin and free insulin-like growth factor I). Conclusion: Long-term adherence to a ketogenic diet can lead to weight loss, tumor size reduction, improved quality of life, improved inflammatory factors, body composition, insulin resistance, and serum lipid profile disorders in breast cancer patients. Clinical trials are suggested to evaluate the effects of ketogenic diets on these metabolic factors, treatment, and quality of life in women with breast cancer. [ABSTRACT FROM AUTHOR]