Breast cancer is a leading cause of mortality among women across the globe. The American Cancer Society predicts that in 2023, there will be 297,790 new breast cancer diagnoses and 43,170 deaths caused by the disease among women in the United States.

Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17–48.

 

The cutting-edge field of nanotechnology has the potential to overcome some of the limitations of conventional therapies for this disease and enhance patient outcomes and quality of life.

 

Limitations of traditional treatments and reconstructions

 

Conventional chemotherapy attacks both healthy and cancer cells, causing toxicity with side effects like hair loss, mucosal ulcerations, and myelosuppression. 

However, this method is frequently plagued with capsular contracture—a condition where a tight, fibrous layer develops around the implant and leads to breast swelling and tenderness. 

Unfortunately, despite treatment with chemotherapy and immunotherapy, up to 40% of breast cancer survivors have a recurrence.

Gerber B, Freund M, Reimer T. Recurrent breast cancer: treatment strategies for maintaining and prolonging good quality of life. Dtsch Arztebl Int. 2010;107(6):85–91.

Recently, implants have been implicated. Researchers publishing in JAMA Surgery found that chronic inflammation around textured implants triggers dormant cancer cells, responsible for breast cancer recurrence.

Lee KT, Kim S, Jeon BJ, et al. Association of the implant surface texture used in reconstruction with breast cancer recurrence. JAMA Surg. 2020;155(12):1132–1140.

 

 

Researchers, physicians, and patients all seek ways to improve chemotherapy's safety profile and to enhance breast reconstruction outcomes following a mastectomy. Is this possible? The answer may lie in an ever-evolving field—nanotechnology.

 

Harnessing the power of nanotechnology

 

Nanotechnology is an exciting field of nanoscale materials—including medical devices, diagnostics, and therapeutic agents—that work at a molecular level.

A diverse range of nanoformulations is currently being developed, which include liposomes, nanofibers, nanocapsules, dendrimers, and nanoparticles. Studies have already yielded promising results, producing evidence of their ability to prevent cancer cell proliferation, lessen the risk of recurrence, and minimise the chance of post-chemotherapy metastasis.

 

Nano-texturisation for breast implants

 

 

Nano-texturisation can improve breast implants' design and performance using techniques like soft-tissue engineering, which create natural and artificial scaffolds to encourage cell growth and promote tissue regeneration.

The goal is to make synthetic implant materials that behave more like human collagen, and obviate the risk of inflammation and prevent tumor recurrence. Examples include the following, as discussed by the authors of the Asian Journal of Surgery article:

1. Acellular dermal matrices 

2. Drug-eluting nanofibers

3. PLGA (polylactic-co-glycolic acid) implant surfaces

4. Chemo-releasing magnetic hydrogels

 

Nanoparticles for targeting breast cancer cells

 

By encapsulating drugs, advanced gene therapies, or growth factors with nanoparticles, the biological half-life of anticancer drugs can be enhanced, allowing the administration of lower doses without compromising peak efficacy.

As discussed in a review article in Nanomedicine (Lond), and also in the Asian Journal of Surgery, these include nanoparticle albumin-bound drug complex like (nab™) paclitaxel. cytotoxic siRNA, nanoparticle-mediated photothermal ablation (PTA), and calcium phosphosilicate nanoparticles like docetaxel-doped calcium phosphosilicate nanoparticles (CPSNPs).

Alshareeda AT, Nur Khatijah MZ, Al-Sowayan BS. Nanotechnology: a revolutionary approach to prevent breast cancer recurrence. Asian Journal of Surgery. 2023;46(1):13–17.

Li Y, Gong S, Pan W, et al. A tumor acidity activatable and Ca2+-assisted immuno-nanoagent enhances breast cancer therapy and suppresses cancer recurrence. Chem Sci. 2020;11(28):7429–7437.

 

 

Nanotheranostics

 

Nanotheranostics is an amalgamation of nanotechnology, therapy, and diagnostics.

Kalash RS, Lakshmanan VK, Cho C, et al. Theranostics, In: Ebara M, ed. Biomaterials Nanoarchitectonics. New York: Elsevier; 2016:197–215.

Examples include combining optical imaging with nanoparticles, such as bioluminescence and fluorescence imaging. These cancer-specific nanoimaging agents are also conjugated with biomolecules or drug molecules, for more specific targeting of cancer cells. 

 

Researchers have also combined infrared dyes and metal nanoparticles for fluorescence imaging to aid in the diagnosis and treatment of breast cancer.