Recent Advances in Breast Cancer Imaging 2026

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 4375

Special Issue Editor


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Guest Editor
Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, NY 10467, USA
Interests: breast imaging; AI/machine learning in prediction of breast cancer prognosis and pathological complete response; multiparametric and longitudinal MRI in multimodal prediction models for the prediction of breast cancer prognosis and pCR; diagnostic radiology
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Special Issue Information

Dear Colleagues,

We are delighted to extend an invitation for the submission of your cutting-edge original or review research papers on breast cancer imaging. As breast cancer remains one of the most prevalent and pressing health concerns globally, the significance of advanced imaging techniques in its detection, characterization, and treatment evaluation cannot be overstated. We welcome submissions exploring a wide array of topics, including the following:

  • The development and optimization of novel imaging modalities such as magnetic resonance imaging (MRI), digital breast tomosynthesis (DBT), and contrast-enhanced mammography for early detection and risk stratification of breast lesions;
  • Advancements in quantitative imaging biomarkers and artificial intelligence algorithms to improve diagnostic accuracy, prognostication, and treatment response assessment; elucidation of the role of imaging in guiding personalized treatment strategies, including neoadjuvant chemotherapy planning, surgical margin assessment, and post-treatment surveillance;
  • Exploration of imaging-based techniques for assessing tumor heterogeneity, microenvironmental factors, and molecular subtypes to inform precision medicine approaches;
  • The integration of multimodal imaging approaches provides comprehensive insights into the complex biology of breast cancer progression and metastasis.

We also welcome machine learning analysis of breast images. Your contributions have the potential to revolutionize breast cancer care by enhancing early detection, optimizing treatment strategies, and improving patient outcomes.

Prof. Dr. Takouhie Catherine Maldjian
Guest Editor

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Keywords

  • breast cancer
  • neoadjuvant chemotherapy
  • axillary lymph nodes
  • molecular subtypes
  • hormonal receptor positive
  • medical oncology
  • breast surgery
  • breast cancer metastasis
  • pathological complete response
  • breast cancer recurrence clinical impact and innovation
  • diagnostic
  • prognosis
  • markers
  • imaging

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Published Papers (3 papers)

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Research

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18 pages, 2182 KB  
Article
Quantitative Evaluation of Pectoral Muscle Visualisation as an Indicator of Positioning Quality in Screening Mammography
by Maja Karić, Doris Šegota Ritoša and Petra Valković Zujić
Diagnostics 2026, 16(8), 1218; https://doi.org/10.3390/diagnostics16081218 - 19 Apr 2026
Viewed by 386
Abstract
Background/Objectives: Image quality of mammograms in breast cancer screening is strongly operator-dependent, particularly in the mediolateral oblique (MLO) projection where adequate visualisation of the pectoralis major muscle serves as a surrogate marker of posterior tissue inclusion. Current positioning assessment is predominantly qualitative and [...] Read more.
Background/Objectives: Image quality of mammograms in breast cancer screening is strongly operator-dependent, particularly in the mediolateral oblique (MLO) projection where adequate visualisation of the pectoralis major muscle serves as a surrogate marker of posterior tissue inclusion. Current positioning assessment is predominantly qualitative and subject to inter-observer variability. This study aimed to quantitatively evaluate pectoral muscle visualisation and compression force variability among radiographers participating in a national screening programme. Methods: A retrospective observational study was conducted at Clinical Hospital Center Rijeka in January and February 2020. A total of 464 digital MLO mammograms were analysed. Images from nine radiographers were randomly retrieved from the institutional Picture Archiving and Communication System (PACS). Pectoral muscle length and width were measured using a standard clinical workstation with an integrated distance measurement tool. Additional variables included radiographer gender, breast side (LMLO vs. RMLO), imaging order, and applied compression force. Statistical analyses included Welch’s ANOVA, one-way ANOVA, t-tests, and appropriate post hoc comparisons. Results: Across all MLO projections, the combined mean pectoral muscle width was 41.0 ± 11.4 mm and the mean length was 134.3 ± 21.7 mm. Significant inter-operator differences were observed in pectoral muscle width (p < 0.001) and length (p = 0.023). Mean muscle width ranged from 35.0 mm to 54.2 mm, and mean length from 126.5 mm to 139.4 mm across radiographers. No significant differences were found with respect to radiographer gender, breast side, or imaging order (all p > 0.05). Compression force differed significantly among radiographers (p < 0.001), ranging from 117.0 ± 18.3 N to 184.8 ± 33.9 N. Conclusions: This study demonstrates significant inter-operator variability in both pectoral muscle visualisation and applied compression force during MLO mammography. These findings indicate that important technical aspects of mammographic examination remain strongly operator-dependent and highlight the need for more consistent positioning practices within screening programmes. Quantitative measurement of pectoral muscle dimensions may serve as a practical and objective approach for monitoring positioning quality and supporting quality assurance in routine clinical practice. Full article
(This article belongs to the Special Issue Recent Advances in Breast Cancer Imaging 2026)
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11 pages, 697 KB  
Article
Contrast-Enhanced Mammography vs. Breast MRI for Assessing Neoadjuvant Chemotherapy Response: A Prospective Clinical Comparison Study
by Omer Acar, Çağdaş Rıza Açar, İhsan Sebnem Orguc, Ferhat Ekinci, Mustafa Sahbazlar and Atike Pınar Erdoğan
Diagnostics 2026, 16(4), 640; https://doi.org/10.3390/diagnostics16040640 - 23 Feb 2026
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Abstract
Objective: To compare contrast-enhanced mammography (CEM) with breast magnetic resonance imaging (MRI) in evaluating residual tumor size and pathological complete response after neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods: This prospective study included patients with histopathologically confirmed breast cancer who [...] Read more.
Objective: To compare contrast-enhanced mammography (CEM) with breast magnetic resonance imaging (MRI) in evaluating residual tumor size and pathological complete response after neoadjuvant chemotherapy (NAC) in breast cancer patients. Methods: This prospective study included patients with histopathologically confirmed breast cancer who were scheduled to receive NAC followed by surgery. All patients underwent both CEM and breast MRI before initiation of NAC and within seven days after completion of treatment. Surgery was performed at a median of 14 days after post-treatment imaging. Residual tumor size measurements obtained by both imaging modalities were compared with histopathological findings, which served as the reference standard. Pathological complete response was defined as the absence of residual invasive carcinoma in the surgical specimen. Results: A total of 74 female patients were included. CEM estimated residual tumor size within ±1 cm of histopathology in 84.7% of cases, whereas MRI achieved this accuracy in 76.4%. Agreement with histopathology was higher for CEM than for MRI. In predicting pathological complete response, CEM demonstrated higher sensitivity (91.3%) and negative predictive value compared with MRI; however, this difference did not reach statistical significance (p = 0.24). MRI showed slightly higher specificity. Pathological complete response was observed in 31.1% of patients. Conclusion: Contrast-enhanced mammography demonstrated performance comparable to breast MRI in assessing response to neoadjuvant chemotherapy, with numerically higher sensitivity for predicting pathological complete response. CEM may represent a practical and accessible alternative to MRI, particularly in settings where MRI is unavailable or contraindicated. These findings support the clinical use of CEM as a reliable alternative imaging modality for response assessment. Full article
(This article belongs to the Special Issue Recent Advances in Breast Cancer Imaging 2026)
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Review

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12 pages, 388 KB  
Review
Review of Prognostic Significance of Quantitative BPE Measurements
by Jeremy Weiss, Emily Hunt, Yihui Zhu, Tim Q. Duong and Takouhie Maldjian
Diagnostics 2026, 16(3), 495; https://doi.org/10.3390/diagnostics16030495 - 6 Feb 2026
Cited by 1 | Viewed by 2182
Abstract
Background/Objectives: Background parenchymal enhancement (BPE) on breast magnetic resonance imaging reflects hormonal and vascular activity of fibroglandular tissue and is studied as a prognostic marker for breast cancer. This paper serves as a review that evaluates quantitative methods for BPE measurements for [...] Read more.
Background/Objectives: Background parenchymal enhancement (BPE) on breast magnetic resonance imaging reflects hormonal and vascular activity of fibroglandular tissue and is studied as a prognostic marker for breast cancer. This paper serves as a review that evaluates quantitative methods for BPE measurements for predicting treatment outcomes. Methods: PubMed was searched for papers on evaluating BPE with outcomes to compare, such as pathologic complete response, recurrence-free survival, disease-free survival, and overall survival, from 2015 to 2025. In total, eleven papers using quantitative methods to measure BPE were selected. Results: Quantitative results showed that BPE reduction during neoadjuvant chemotherapy and high pre-treatment/baseline BPE are linked to improved treatment response and reduced risk of recurrence. Conclusions: Quantitative assessment methods yield objective and reproducible prognostic information. Incorporating quantitative BPE measurements alongside tumor-focused imaging features may further improve predictive accuracy in clinical settings. Full article
(This article belongs to the Special Issue Recent Advances in Breast Cancer Imaging 2026)
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