DNA-Aptamers-Therapeutics Reloaded Tools in Breast Cancer

Breast cancer remains a major global health challenge, strongly influenced by inequities in access to high-cost antibody-based diagnostic and therapeutic technologies. Because their manufacturing requires complex and expensive bioproduction systems, many regions, particularly in Latin America, face limited availability of tools essential for early detection and targeted treatment. This gap has highlighted the need for cost-effective and scalable theranostic alternatives, driving interest in aptamers, synthetic DNA or RNA oligomers selected through SELEX technology that fold into functional structures with high affinity, low immunogenicity, and reproducible chemical synthesis. Aptamers have expanded the landscape of diagnostic platforms by enabling sensitive aptasensors, liquid biopsy strategies, and nanomedicine-based imaging systems. They also contribute to targeted therapy by recognizing cancer biomarkers with precision and enabling controlled drug delivery. This review critically integrates advances in aptamer-based theranostics for breast cancer, examining their molecular mechanisms, including structural folding, selective ligand binding, and nanomaterial interfacing. We also discuss their application in extracellular vesicle capture, cancer stem cell detection, and therapeutic conjugates, emphasizing their advantages and limitations relative to antibody-based approaches. By consolidating current evidence, this work positions aptamers as emerging tools capable of democratizing precision oncology, particularly in regions where access to advanced technologies remains limited.