4D printed multipurpose smart implants for breast cancer management.

Area of Science:

• Biomaterials Science
• Cancer Therapy
• Surgical Oncology

Background:

• Breast-conserving surgery (BCS) is standard for early breast cancer but can lead to local recurrence and tissue loss.
• Adjuvant therapies like radiotherapy and systemic treatments improve survival but cause side effects and prolonged treatment durations.
• A patient-centered approach is crucial due to tumor heterogeneity and variable prognoses.

Purpose of the Study:

• To develop a multipurpose 4D printed implant for breast cancer patients undergoing BCS.
• To create a personalized implant capable of size adaptation for improved aesthetic outcomes.
• To incorporate doxorubicin (DOX) for localized anticancer effects and prevention of recurrence.

Main Methods:

• Rheological characterization to assess printability of a carboxymethyl cellulose (CMC) and cellulose nanocrystal (CNC) blend.
• 4D printing of DOX-loaded implants with programmed shape transformation via swelling.
• In vitro studies including swelling tests, drug release, and cytotoxicity assays on MDA-MB-231 breast cancer cells.

Main Results:

• The 4D implant demonstrated programmable morpho transformation, adapting its size through swelling.
• In vitro release studies confirmed drug delivery capabilities.
• The implant exhibited significant in vitro anticancer activity, reducing MDA-MB-231 cell viability by 58% after 72 hours, even after 4 weeks.

Conclusions:

• The developed 4D printed implant shows potential for personalized reconstruction after BCS, filling surgical voids.
• The implant's ability to deliver doxorubicin locally offers a strategy to mitigate local recurrence.
• This smart biomaterial represents a promising patient-centered approach to enhance outcomes in breast cancer treatment.