Scaffold-guided breast reconstruction: A review of current scaffold architectures, materials and fabrication methods.

Breast cancer (BC) remains one of the most prevalent malignancies globally, with mastectomy frequently required as part of treatment. This creates a critical clinical demand for effective breast reconstruction strategies. Conventional reconstruction methods, such as silicone implants, autologous fat grafting, and free-flap surgery, have notable drawbacks. Scaffold-guided breast reconstruction (SGBR) is a promising alternative that relies on biocompatible, biodegradable scaffolds to support and direct the regeneration of vascularized soft tissue. This review summarizes the current state of SGBR approaches, emphasizing scaffold architecture, biomaterials, and fabrication techniques. Various scaffold configurations, including fibrous, porous, hydrogel-based, mesh-like, and composite architectures, are discussed, along with natural and synthetic polymeric biomaterials. The integration of advanced additive manufacturing (AM) technologies is also explored, highlighting their role in enabling patient-specific scaffold designs. The review outlines key biological and mechanical criteria for a successful reconstruction, with particular attention to challenges such as neovascularization and tumor recurrence. Although preclinical studies have yielded promising outcomes, clinical translation remains limited, highlighting the need for continued research to optimize scaffold functionality, integration, and long-term performance.