Nanoparticles for fluorescence-guided breast cancer surgery: advances in in vivo preclinical research

Breast cancer remains the most common malignancy among women worldwide. Incomplete tumor resection continues to be a major challenge during breast cancer surgery, leading to increased risk of local recurrence and the need for additional treatments. Fluorescence-guided surgery (FGS) is a promising method for real-time intraoperative identification of tumors, tumor margins, and metastatic lymph nodes. In recent years, fluorescent nanoparticles have been developed that surpass traditional fluorophores with enhanced signal intensity and photostability, tumor retention and targeting, and multimodal capabilities. This review summarizes recent advances in nanoparticle-assisted fluorescence-guided surgery for breast cancer in preclinical in vivo models, including both inorganic and organic nanoparticles. The review focuses on nanoparticle physicochemical and photophysical properties, targeting strategies, imaging performance using in vivo preclinical breast cancer models, and reported clearance pathways and safety profiles. Despite the remaining translational challenges, significant progress is being made in the preclinical development of innovative nanoparticle imaging agents for fluorescence-guided surgery of breast cancer, which demonstrates their potential application for clinical studies.