Generic placeholder image

Current Medical Imaging


ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Review Article

A Review of Spectroscopic and Non-Spectroscopic Techniques for Diagnosing Breast Cancer

Author(s): S. Stella Jenifer Isabella, K.A. Sunitha*, Sridhar P. Arjunan and Bala Pesala

Volume 19, Issue 6, 2023

Published on: 26 September, 2022

Page: [535 - 545] Pages: 11

DOI: 10.2174/1573405618666220509114727

Price: $65


Malignancy, one of the leading causes of death worldwide, accounts for 9.6 million deaths in 2018. Around 1 out of 6 deaths are the direct result of the malignancy. Clinicians claim that age and breast density are two preliminary factors increasing the risk of cancer. The mortality rate brought about by malignant growth in low and high income countries is, for the most part, around 70%. Imaging techniques play a vital role in the detection, and staging, thereby helping in treatment decision making. This review paper presents a comprehensive survey involving a literature study about the evolution and efficacy of various breast cancer detection techniques. This work studies various procedures of imaging techniques such as mammograms, ultrasound, MRI, PET, CT, Terahertz Spectroscopy, Raman Spectroscopy, Optical coherence Tomography, Mass spectroscopy, diffuse reflectance spectroscopy, and Infrared Thermography. Since cancer is a complicated illness with diverse pathophysiologies, numerous modifications of the fundamental detection approach employed in each of these modalities have been performed throughout the years to increase the detection efficiency. This paper covers basic preliminary results with FFPE breast cancer blocks of malignant and normal subjects using THz Techniques that are presented as proof of concept to carry out further research.

Keywords: Breast cancer, spectroscopic techniques, non-spectroscopic techniques, FFPE samples, optical properties, terahertz-TDS.

Graphical Abstract
World Health Organization health-topic/cancer 2018. Available from:
Avril N, Adler LP. F-18 fluoro-de-oxy-glucose-positron emission tomography imaging for primary breast cancer and loco-regional staging. PET Clin 2006.
Sickles EA. Breast masses: Mammographic evaluation. Radiol 1989; 173(2): 297-303.
Lee CH. Screening mammography: Proven benefit, continued controversy. Radiol Clin North Am 2002; 40(3): 395-407.
[] [PMID: 12117183]
Maloney BW, McClatchy DM III, Pogue BW, Paulsen KD, Wells WA, Barth RJ. Review of methods for intraoperative margin detection for breast conserving surgery. J Biomed Opt 2018; 23(10): 1-19.
[] [PMID: 30369108]
American Cancer Society. Testing biopsy and cytology specimens for cancer
Li Y, Qi X, Lei C, Yue Q, Zhang S. Simultaneous SERS detection and imaging of two biomarkers on the cancer cell surface by self-assembly of branched DNA-gold nanoaggregates. Chem Commun (Camb) 2014; 50(69): 9907-9.
[] [PMID: 25030218]
Fine RE, Staren ED. Updates in breast ultrasound. Surg Clin North Am 2004; 84(4): 1001-34.
[] [PMID: 15261751]
Kaye EA, Granlund KL, Morris EA, Maybody M, Solomon SB. Closed-bore interventional MRI: Percutaneous biopsies and ablations. AJR Am J Roentgenol 2015; 205(4)W400-10
[] [PMID: 26397347]
Purushotham Anand D. Pepper Michael, Wallace Vincent P, et al. Terahertz pulsed spectroscopy of freshly excised human breast cancer. 2009; 17(15): 12444-54.
Coleman RE, Delbeke D, Guiberteau MJ, et al. American College of Radiology; Society of Nuclear Medicine; Society of Computed Body Tomography and Magnetic Resonance. Concurrent PET/CT with an integrated imaging system: Intersociety dialogue from the joint working group of the American College of Radiology, the Society of Nuclear Medicine, and the Society of Computed Body Tomography and Magnetic Resonance. J Nucl Med 2005; 46(7): 1225-39.
Kandlikar S, Perez-Raya I, Raghupathi P, et al. Infrared imaging technology for breast cancer detection – Current status, protocols and new directions. Int J Heat Mass Transf 2017; 108: 2303-20.
Gubarkova EV, Kiseleva EB, Sirotkina MA, et al. Diagnostic accuracy of cross-polarization oct and oct-elastography for differentiation of breast cancer subtypes: Comparative study. Diagnostics 2020; 10(12): 994.
Balog J, Sasi-Szabó L, Kinross J, et al. Intraoperative tissue identification using rapid evaporative ionization mass spectrometry. Sci Transl Med 2013; 5(194)194ra93
[] [PMID: 23863833]
Bigio IJ, Bown SG, Briggs G, et al. Diagnosis of breast cancer using elastic-scattering spectroscopy: Preliminary clinical results. J Biomed Opt 2000; 5(2): 221-8.
Majumder SK, Gupta PK, Jain B, Uppal A. UV excited autofluorescence spectroscopy of human breast tissues for discriminating cancerous tissue from benign tumor and normal tissue. Lasers Life Sci 1998; 8: 249-64.
Institute of Medicine (US) and National Research Council (US) Committee on Technologies for the Early Detection of Breast Cancer. Nass SJ, Henderson IC, Lashof JC, Eds. Mammography and Beyond: Developing Technologies for the Early Detection of Breast Cancer. Washington (DC): National Academies Press 2001.
Mushlin AI, Kouides RW, Shapiro DE. Estimating the accuracy of screening mammography: A meta-analysis Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews York, UK. Centre for Reviews and Dissemination (UK) 1998.
Nelson HD, Fu R, Cantor A, Pappas M, Daeges M, Humphrey L. Effectiveness of breast cancer screening: Systematic review and meta-analysis to update the 2009 U.S. preventive services task force recommendation. Ann Intern Med 2016; 164(4): 244-55.
[] [PMID: 26756588]
Lee CS, Moy L, Friedewald SM, Sickles EA, Monticciolo DL. Harmonizing breast cancer screening recommendations: Metrics and accountability. AJR Am J Roentgenol 2018; 210(2): 241-5.
[] [PMID: 29045178]
Boyd NF, Guo H, Martin LJ, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med 2007; 356(3): 227-36.
[] [PMID: 17229950]
Bryan TJ, Estrada CA, Castiglioni A, Snyder ED. Impact of an educational intervention on provider knowledge, attitudes, and comfort level regarding counseling women ages 40-49 about breast cancer screening. J Multidiscip Healthc 2015; 8: 209-16.
[] [PMID: 25999731]
Park JM, Franken EA Jr, Garg M, Fajardo LL, Niklason LT. Breast tomosynthesis: Present considerations and future applications. Radiographics. Suppl 2007; 1(S2): 31-40.
Zou Y, Guo Z. A review of electrical impedance techniques for breast cancer detection. Med Eng Phys 2003; 25(2): 79-90.
[] [PMID: 12538062]
Berrington de González A, Reeves G. Mammographic screening before age 50 years in the UK: Comparison of the radiation risks with the mortality benefits. Br J Cancer 2005; 93(5): 590-6.
[] [PMID: 16136033]
Ciatto S, Houssami N, Bernardi D, et al. Integration of 3D digital mammography with tomosynthesis for population breast-cancer screening (STORM): A prospective comparison study. Lancet Oncol 2013; 14(7): 583-9.
[] [PMID: 23623721]
Nover AB, Jagtap S, Anjum W, et al. Modern breast cancer detection: A technological review. Int J Biomed Imaging 2009; 2009902326
[] [PMID: 20069109]
Bhavika K. Contrast enhanced spectral mammography: A review. Seminars in Ultrasound. CT and MRI 2018; 39(1): 70-9.
Campbell S. A short history of sonography in obstetrics and gynaecology. Facts Views Vis ObGyn 2013; 5(3): 213-29.
[PMID: 24753947]
Giuliano V, Giuliano C. Improved breast cancer detection in asymptomatic women using 3D-automated breast ultrasound in mammographically dense breasts. May-Jun 2013; 37(3): 480-6.
[] [PMID: 23116728]
Doyle TE, Factor RE, Ellefson CL, et al. High-frequency ultrasound for intraoperative margin assessments in breast conservation surgery: A feasibility study. BMC Cancer 2011; 11(1): 444.
[] [PMID: 21992187]
Guo R, Lu G, Qin B, Fei B. Ultrasound imaging technologies for breast cancer detection and management: A review. Ultrasound Med Biol 2018; 44(1): 37-70.
[] [PMID: 29107353]
Smith FW, Hutchison JM, Mallard JR, et al. Oesophageal carcinoma demonstrated by whole-body nuclear magnetic resonance imaging. Br Med J (Clin Res Ed) 1981; 282(6263): 510-2.
Grimsby GM, Gray R, Dueck A, et al. Is there concordance of invasive breast cancer pathologic tumor size with magnetic resonance imaging? Am J Surg 2009; 198(4): 500-4.
Ines V, Rueckert M, Kagan KO. Measurement of tumour size with mammography, sonography and magnetic resonance imaging as compared to histological tumour size in primary breast cancer. BMC Cancer 2013; 13(1)
Bartella L, Liberman L, Morris EA, Dershaw DD. Nonpalpable mammographically occult invasive breast cancers detected by MRI. AJR Am J Roentgenol 2006; 186(3): 865-70.
[] [PMID: 16498122]
Vaughan CL. Novel imaging approaches to screen for breast cancer: Recent advances and future prospects. Med Eng Phys 2019; 72: 27-37.
Peters NH, Borel Rinkes IH, Zuithoff NP, Mali WP, Moons KG, Peeters PH. Meta-analysis of MR imaging in the diagnosis of breast lesions. Radiology 2008; 246(1): 116-24.
[] [PMID: 18024435]
Radhakrishna S, Agarwal S, Parikh PM, et al. Role of magnetic resonance imaging in breast cancer management. South Asian J Cancer 2018; 7(2): 69-71.
Chen X, Moore MO, Lehman CD, et al. Combined use of MRI and PET to monitor response and assess residual disease for locally advanced breast cancer treated with neoadjuvant chemotherapy. Acad Radiol 2004; 11(10): 1115-24.
[] [PMID: 15530804]
Sim LS, Hendriks JH, Bult P, Fook-Chong SM. US correlation for MRI-detected breast lesions in women with familial risk of breast cancer. Clin Radiol 2005; 60(7): 801-6.
Avril N, Rosé CA, Schelling M, et al. Breast imaging with positron emission tomography and fluorine-18 fluorodeoxyglucose: Use and limitations. J Clin Oncol 2000; 18(20): 3495-502.
[] [PMID: 11032590]
Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiol 2004; 231(2): 305-32.
Eary JF, Hawkins DS, Rodler ET, Conrad EU III. (18)F-FDG PET in sarcoma treatment response imaging. Am J Nucl Med Mol Imaging 2011; 1(1): 47-53.
[PMID: 23133794]
Rakheja R, Makis W, Skamene S, et al. Correlating metabolic activity on 18F-FDG PET/CT with histopathologic characteristics of osseous and soft-tissue sarcomas: A retrospective review of 136 patients. AJR Am J Roentgenol 2012; 198(6): 1409-16.
[] [PMID: 22623556]
Pfannenberg AC, Oechsle K, Bokemeyer C, et al. The role of [(18)F] FDG-PET, CT/MRI and tumor marker kinetics in the evaluation of post chemotherapy residual masses in metastatic germ cell tumors--prospects for management. World J Urol 22(2): 132-9.
Crippa F, Seregni E, Agresti R, et al. Association between [18F]fluorodeoxyglucose uptake and postoperative histopathology, hormone receptor status, thymidine labelling index and p53 in primary breast cancer: A preliminary observation. Eur J Nucl Med 1998; 25(10): 1429-34.
Baslaim MM, Bakheet SM, Bakheet R, Ezzat A, El-Foudeh M, Tulbah A. 18-Fluorodeoxyglucose-positron emission tomography in inflammatory breast cancer. World J Surg 2003; 27(10): 1099-104.
Rangarajan V, Purandare NC, Sharma AR, Shah S. PET/CT: Current status in India. Indian J Radiol Imaging 2008; 18(4): 290-4.
[] [PMID: 19774183]
Klimberg VS, Kepple J, Shafirstein G, et al. eRFA: Excision followed by RFA-a new technique to improve local control in breast cancer. Ann Surg Oncol 2006; 13(11): 1422-33.
[] [PMID: 17009144]
V. (51) eronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow- up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 2002; 347(16): 1227-32.
[] [PMID: 12393819]
Moran MS, Schnitt SJ, Giuliano AE, et al. Society of surgical oncology-American society for radiation oncology consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stages I and II invasive breast cancer. Int J Radiat Oncol Biol Phys 2014; 88(3): 553-64.
Roukos DH, Kappas AM, Agnantis NJ. Perspectives and risks of breast-conservation therapy for breast cancer. Ann Surg Oncol 2003; 10(7): 718-21.
[] [PMID: 12900361]
Cabioglu N, Hunt KK, Sahin AA, et al. Role for intraoperative margin assessment in patients undergoing breast-conserving surgery. Ann Surg Oncol 2007; 14(4): 1458-71.
[] [PMID: 17260108]
Hassan AM, El-Shenawee M. Review of electromagnetic techniques for breast cancer detection. IEEE Rev Biomed Eng 2011; 4: 103-18.
[] [PMID: 22273794]
IEEE Standard Letter Designations for Radar-Frequency Bands. New York, NY, USA: IEEE 1984.
Garini Y, Young IT, McNamara G. Spectral imaging: Principles and applications. Cytometry A 2006; 69(8): 735-47.
Jermyn M, Desroches J, Aubertin K, et al. A review of Raman spectroscopy advances with an emphasis on clinical translation challenges in oncology. Phys Med Biol 2016; 61(23): R370-400.
[] [PMID: 27804917]
Kong K, Kendall C, Stone N, Notingher I. Raman spectroscopy for medical diagnostics-From in-vitro biofluid assays to in-vivo cancer detection. Adv Drug Deliv Rev 2015; 89: 121-34.
Santos IP, Barroso EM, Bakker Schut TC, et al. Raman spectroscopy for cancer detection and cancer surgery guidance: Translation to the clinics. Analyst (Lond) 2017; 142(17): 3025-47.
[] [PMID: 28726868]
Frank CJ, McCreery RL, Redd DC. Raman spectroscopy of normal and diseased human breast tissues. Anal Chem Mar 1995; 67(5): 777-83.
Keller MD, Majumder SK, Mahadevan-Jansen A. Spatially offset Raman spectroscopy of layered soft tissues. Opt Lett 2009; 34(7): 926-8.
[] [PMID: 19340173]
Abramczyk H, Brozek-Pluska B, Surmacki J, Jablonska-Gajewicz J, Kordek R. Raman ‘optical biopsy’ of human breast cancer. Prog Biophys Mol Biol 2012; 108(1-2): 74-81.
[] [PMID: 22122914]
Brozek-Pluska B, Musial J, Kordek R, Bailo E, Dieing T, Abramczyk H. Raman spectroscopy and imaging: Applications in human breast cancer diagnosis. Analyst (Lond) 2012; 137(16): 3773-80.
[] [PMID: 22754917]
Haka AS, Volynskaya Z, Gardecki JA, et al. In vivo margin assessment during partial mastectomy breast surgery using raman spectroscopy. Cancer Res 2006; 66(6): 3317.
Thomas G, Nguyen TQ, Pence IJ, et al. Evaluating feasibility of an automated 3-dimensional scanner using Raman spectroscopy for intraoperative breast margin assessment. Sci Rep 2017; 7(1): 13548.
[] [PMID: 29051521]
Redd D, Feng Z, Yue K, Gansler T. Raman spectroscopic characterization of human breast tissues: Implications for breast cancer diagnosis. Appl Spectrosc 1993; 47: 787-91.
Kennedy DA, Lee T, Seely D. A comparative review of thermography as a breast cancer screening technique. Integr Cancer Ther 2009; 8(1): 9-16.
Ng EY-K. A review of thermography as promising non-invasive detection modality for breast tumor. Int J Therm Sci 2009; 48(5): 849-59.
Gautherie M. Thermobiological assessment of benign and malignant breast diseases. Am J Obstet Gynecol 1983; 147(8): 861-9.
[] [PMID: 6650622]
Pavithra PR, Ravichandran KS, Sekar KR, Manikandan R. The effect of thermography on breast cancer detection. Sys Rev Pharm 2018; 9(1): 10-6.
Alfano RR, Asima Pradhan GC. Optical spectroscopic diagnosis of cancer and normal breast tissues Erratum. J Opt Soc Am 1990; 7: 1-393.
St John ER, Al-Khudairi R, Balog J, et al. Rapid evaporative ionisation mass spectrometry towards real time intraoperative oncological margin status determination in breast conserving surgery. 38th Annual San Antonio Breast Cancer Symposium. San Antonio. 2016.
Vahrmeijer AL, Hutteman M, van der Vorst JR, van de Velde CJ, Frangioni JV. Image-guided cancer surgery using near-infrared fluorescence. Nat Rev Clin Oncol 2013; 10(9): 507-18.
[] [PMID: 23881033]
Pickwell E, Cole BE, Fitzgerald AJ, Pepper M, Wallace VP. In vivo study of human skin using pulsed terahertz radiation. Phys Med Biol 2004; 49(9): 1595-607.
Joseph CS, Yaroslavsky AN, Neel VA, Goyette TM, Giles RH. Continuous wave terahertz transmission imaging of non-melanoma skin cancers. Lasers Surg Med 2011; 43(6): 457-62.
Zaytsev KI, Kudrin KG, Karasik VE, Reshetov IV, Yurchenko SO. In vivo terahertz spectroscopy of pigmentary skin nevi: Pilot study of non-invasive early diagnosis of dysplasia. Appl Phys Lett 2015; 106(5)053702
El-Shenawee M, Vohra N, Bowman T, Bailey K. Cancer detection in excised breast tumors using terahertz imaging and spectroscopy. Biomed Spectrosc Imaging 2019; 8(1-2): 1-9.
[] [PMID: 32566474]
Yu C, Fan S, Sun Y, Pickwell-Macpherson E. The potential of terahertz imaging for cancer diagnosis: A review of investigations to date. Quant Imaging Med Surg 2012; 2(1): 33-45.
Doradla P, Alavi K, Joseph C, Giles R. Detection of colon cancer by continuous-wave terahertz polarization imaging technique. J Biomed Opt 2013; 18(9): 90504.
Fitzgerald AJ, Wallace VP, Jimenez-Linan M, et al. Terahertz pulsed imaging of human breast tumors. Radiol 2006; 239(2): 533-40.
Brun MA, Formanek F, Yasuda A, Sekine M, Ando N, Eishii Y. Terahertz imaging applied to cancer diagnosis. Phys Med Biol 2010; 55(16): 4615-23.
Bowman T, El-Shenawee M, Campbell LK. Terahertz transmission vs. reflection imaging and model-based characterization for excised breast carcinomas. Biomed Opt Express 2016; 7(9): 3756-83.
Bowman T, El-Shenawee M. Terahertz spectroscopy for the characterization of excised human breast tissue. Proc IEEE International Microwave Symposium (IMS). Tampa, FL. 2014.

Rights & Permissions Print Export Cite as
© 2023 Bentham Science Publishers | Privacy Policy