Breast Cancer Imaging Techniques and Diagnostics

Breast cancer imaging encompasses a spectrum of modalities that enable early detection, accurate characterisation and guidance for intervention. Traditional two-dimensional digital mammography remains the cornerstone of screening programmes, offering high resolution of microcalcifications and mass morphology. Advances such as digital breast tomosynthesis add a three-dimensional perspective, reducing tissue overlap and improving lesion conspicuity. Ultrasonography, including shear wave elastography, supplements mammography in dense breasts by assessing tissue stiffness and vascularity. Multiparametric magnetic resonance imaging (MRI) combines contrast-enhanced sequences with diffusion-weighted imaging to evaluate tumour vascularity and cellular density, enhancing specificity in high-risk populations and monitoring response to neoadjuvant therapy. Emerging techniques such as contrast-enhanced spectral mammography and positron emission mammography integrate functional data with anatomical detail. Concurrently, computational methods—from deep learning classifiers to physics-based registration algorithms—are being incorporated to optimise lesion detection, risk stratification and interventional planning. Collectively, these innovations are driving personalised screening strategies, reducing overdiagnosis and guiding minimally invasive treatments on a global scale.

Research from Nature Portfolio

Recent studies have shown that an artificial intelligence model applied to routine mammograms can effectively triage a small subset of individuals for supplemental MRI. In a randomised clinical trial, use of an AI-derived score to select participants with negative mammograms led to a fourfold increase in cancer detection per MRI examination compared with standard breast density criteria. The additional cancers identified were predominantly invasive and multifocal, demonstrating the clinical impact of targeted MRI screening and suggesting a cost per cancer detected comparable to that of initial mammography.

Breast Cancer Imaging Techniques and Diagnostics publication trend

The graph below shows the total number of articles in breast cancer imaging techniques and diagnostics across all publications each year (not limited to Nature Index journals).

Technical terms

Mammography: X-ray imaging of the breast used for screening and diagnostic evaluation of masses and microcalcifications.

Digital Breast Tomosynthesis (DBT): A volumetric mammographic technique that acquires multiple low-dose projections to reconstruct quasi-three-dimensional breast images.

Shear Wave Elastography: Ultrasound method that quantifies tissue stiffness by measuring the propagation speed of mechanically induced shear waves.

Diffusion-Weighted Imaging (DWI): MRI sequence sensitive to the Brownian motion of water molecules, permitting calculation of the apparent diffusion coefficient for tumour characterisation.

BI-RADS: Breast Imaging Reporting and Data System, a standardised lexicon and assessment structure for mammographic and MRI findings.

Apparent Diffusion Coefficient (ADC): Quantitative parameter derived from DWI reflecting the degree of water molecule diffusion within tissue, inversely related to cellular density.

References

1. AI-based selection of individuals for supplemental MRI in population-based breast cancer screening: the randomized ScreenTrustMRI trial. Nature Medicine (2024).
2. A Deep Learning Decision Support Tool to Improve Risk Stratification and Reduce Unnecessary Biopsies in BI-RADS 4 Mammograms. Radiology Artificial Intelligence (2023).
3. Comparing regularized Kelvinlet functions and the finite element method for registration of medical images to sparse organ data. Medical Image Analysis (2024).
4. Diffusion-weighted imaging of the breast—a consensus and mission statement from the EUSOBI International Breast Diffusion-Weighted Imaging working group. European Radiology (2019).
5. Dual-energy contrast-enhanced digital mammography: initial clinical results of a multireader, multicase study. Breast Cancer Research (2012).
6. Evaluation of Digital Breast Tomosynthesis as Replacement of Full-Field Digital Mammography Using an In Silico Imaging Trial. JAMA Network Open (2018).