Intraductal approach to breast cancer prevention and treatment
Breast cancer remains a significant health challenge worldwide. While advancements in treatment have improved survival rates, the search for more targeted and effective therapies continues. A recent publication by scientists at the University of São Paulo, Brazil — published in the International Journal of Pharmaceutics — sheds light on a promising avenue: nanotechnology can target cancer. Nanotechnology-based intraductal drug delivery aims to revolutionize local treatment and prevention of breast cancer by delivering nanocarriers with therapeutic agents directly to the site of the disease.
Ductal breast cancer treatment
Breast cancer is the leading cause of cancer death among women. The current standard of care for invasive breast cancer involves surgery and radiotherapy, possibly followed by anti-estrogens and other forms of chemotherapy. Multiple side effects can occur.
Ductal carcinoma in situ (DCIS) is an abnormal growth of cells in the breast ducts. It’s usually slow-growing, and less than 55% of cases progress to invasive cancer over time. Because physicians don’t know which individuals with DCIS will develop invasive cancer, treatment usually involves the standard treatment for invasive cancer.
Scientists have been concerned about overtreatment of low-grade DCIS. Less aggressive strategies include active surveillance and the development of biomarkers to predict which individuals will go on to develop invasive cancer. In addition, intraductal approaches to DCIS offer a targeted prevention and treatment option. For background, see our webpage on breast cancer prevention.
Understanding intraductal drug delivery
The breast’s ductal system is where many breast cancers originate. Intraductal drug delivery involves administering medication directly into these ducts instead of through the circulatory system. Using nanotechnology to target breast cancer offers several potential advantages:
- Increased drug concentration at the tumor site: By delivering drugs directly to the affected area, higher concentrations can be achieved, maximizing therapeutic efficacy.
- Reduced systemic toxicity: Avoiding systemic circulation minimizes exposure of healthy tissues to harmful side effects.
- Targeted treatment and prevention: This approach allows for precise targeting of cancerous or precancerous cells within the ductal system.
The role of nanotechnology in intraductal treatment
Nanotechnology plays a crucial role in enhancing intraductal drug delivery. Nanoparticles range from 1 to 100 nanometers in size. To put this into perspective, a human hair is about 80,000 to 100,000 nanometers wide. These tiny particles are engineered to carry drugs through the small ducts and to the affected tissues. Nanoparticles can:
- Improve drug solubility and stability: Many anticancer drugs don’t dissolve well, limiting their effectiveness. Nanoparticles can encapsulate these drugs, improving their solubility and stability.
- Enable controlled drug release: Nanoparticles can be designed to release drugs in a controlled manner, ensuring sustained therapeutic levels at the tumor site.
- Enhance cellular uptake: Nanoparticles can be created with targeting ligands, enabling them to only bind to cancer cells and enhance drug uptake.
- Overcome biological barriers: The ductal system presents barriers to drug delivery. Nanoparticles can be designed to overcome these barriers, improving drug penetration.
The future of nanotechnology for intraductal treatment
The current work using nanoparticles for breast cancer prevention and treatment has the capacity to change treatment practice for DCIS and possibly other breast ailments. Some highlights include:
- The potential of various nanoparticle types, including liposomes, polymers, and synthetic macromolecules called dendrimers, for intraductal drug delivery.
- Optimizing nanoparticle design to achieve targeted drug delivery and controlled release.
- Using nanotechnology to deliver chemotherapeutic agents, gene therapies, and other therapeutic molecules directly to breast cancer cells.
- The possibility of using this technology for preventative measures in high risk individuals.
Figure credit: Passos et al. 2023 doi.org/10.1016/j.ijpharm.2023.122681
Challenges to overcome
While there are many advantages to the use of nanotechnology to target breast cancer, some areas need refinement. The authors of the review paper reported that challenges include identifying and then infusing DCIS-affected ducts, as well as understanding the drug distribution in the ductal tree in humans. Additionally, physicians need to understand metabolization and long-term drug effects in the mammary tissue. Finally, it is necessary to more accurately identify the cases that would benefit from intraductal therapy.
The use of nanotechnology-based intraductal drug delivery holds immense promise for improving breast cancer treatment and prevention. This innovative approach could lead to more effective and less toxic therapies, earlier detection and intervention, and ultimately improved quality of life for breast cancer patients.
