DNA Aptamers: Reloaded Tools for Breast Cancer Therapeutics

Breast cancer continues to be a major challenge in global health, in part due to significant inequalities in access to costly diagnostic and therapeutic technologies based on antibodies. Their manufacturing requires complex and expensive bioproduction systems, resulting in limited availability of these tools-essential for early detection and targeted treatment-in many regions, particularly in Latin America. This gap has highlighted the need for cost-effective and scalable theranostic alternatives, increasing interest in aptamers. Obtained through SELEX technology, aptamers are synthetic DNA or RNA oligomers that fold into functional structures. Among their advantages are high affinity for their target, low immunogenicity, and chemical synthesis, which assures reproducible production. Aptamers have expanded the landscape of diagnostic platforms through the development of sensitive aptasensors, liquid biopsy strategies, and imaging systems based on nanomedicines. They also contribute to targeted therapy by recognizing cancer biomarkers selectively and enabling controlled drug delivery. This review presents a critical summary of advances in aptamer-based theranostics for breast cancer, addressing molecular mechanisms, structural folding, selective ligand binding, and nanomaterial interfacing. We also discuss applications in extracellular vesicle capture, cancer stem cell detection, and therapeutic conjugates, emphasizing their advantages and limitations relative to approaches based on antibodies. Overall, current advances show aptamers as emerging tools capable of democratizing precision oncology, particularly in regions where access to advanced technologies remains limited.