New diagnostic tools for breast cancer

Imaging plays a major role in the diagnosis, treatment, and follow-up of breast cancers. While the effect of secondary prevention by means of population-based mammography screening programs is still a matter of debate, the majority of expert societies are clearly in favor of mammographic screening [ 1 ]. Although imaging is considered the most efficient diagnostic test for detecting breast cancer, screening mammography does not yield perfect results. In dense breasts, cancers that do not present as mammographic microcalcifications are easily missed and mammographic findings such as masses, architectural distortions, asymmetries, and microcalcifications are not specific for breast cancer. As the aim of imaging is to detect cancer, the reader will regularly choose a diagnostic decision leading to further work-up by additional imaging, follow-up examinations, and image-guided biopsies, leading to extra costs, anxiety, and possible physical harm. Therefore, there is an ongoing search for new diagnostic tools in breast cancer. Key methods include three-dimensional (3D) approaches to x‑ray mammography (digital breast tomosynthesis), contrast-enhanced mammography, quantifiable ultrasound techniques (e. g., shear wave elastography), and functional magnetic resonance imaging (MRI; e. g., contrast-enhanced MRI, diffusion-weighted imaging). This review focuses on these techniques and their potential use in the breast clinic.