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Aptamers which are synthetic oligonucleotides that specifically bind to target molecules, offer high affinity, low immunogenicity, and superior tumor penetration compared to antibodies. However, their clinical translation has been limited by instability in biological systems. Spiegelmers, a novel class of mirror-image aptamers composed of L-nucleotides, overcome this limitation through intrinsic nuclease resistance and prolonged serum half-life. These biostable molecules maintain high binding specificity to diverse targets, including proteins, peptides, and microRNAs, enabling applications in both diagnosis and therapy. In breast cancer, spiegelmers demonstrate strong potential for molecular imaging via MRI and PET when conjugated to fluorescent or radioactive labels, as well as for targeted drug delivery and photodynamic or photothermal therapy. 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