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 Breast cancer detection technologies have evolved from conventional histopathology to advanced molecular methods to offer diagnostic insights, informs Ajay Kandhari, managing director, DSS Imagetech Pvt. Ltd.
From relying on basic tissue examination under a microscope to harnessing advanced molecular diagnostics, the evolution of breast cancer detection has redefined how clinicians identify, classify, and treat the disease, saving more lives each year.
Kandhari further explains that the integration of AI-driven tools is bringing precision medicine closer to reality and advanced molecular methods are transforming breast cancer diagnostics from identifying disease to predicting it. Early detection now means more than finding a lump. It means discovering genetic and molecular changes long before symptoms surface.
In the 1950s, breast cancer diagnosis primarily depended on histopathology, where stained tissue samples were examined under a microscope to identify abnormal cells. While this method remains a cornerstone of cancer diagnostics, it often lacked the precision needed to detect molecular changes or genetic predispositions. As a result, diagnosis was largely reactive made after visible symptoms or lumps appeared.
He further informs that legacy companies first began supplying microscopes in India for the detection of breast cancer in the 1950s. This, then expanded to cover the entire ecosystem for microscopy users. The introduction of Immunohistochemistry (IHC) in the late 20th century marked a turning point. IHC enabled the detection of key protein markers such as ER (estrogen receptor), PR (progesterone receptor), and HER2, which not only helped in diagnosis but also guided treatment. This shift laid the foundation for personalized oncology, where therapies could be tailored to a patient’s specific tumour profile rather than a one-size-fits-all approach.
Initially, Immunohistochemistry (IHC) formed the backbone of diagnosis, addressing nearly 80% of breast cancer cases, while the remaining 20% required confirmatory Fluorescence In Situ Hybridization (FISH) testing. As technology advanced, newer molecular tools such as RT-PCR, MLPA/digitalMLPA, and Next-Generation Sequencing (NGS) have enhanced precision and expanded diagnostic possibilities. Soon after, Fluorescence In Situ Hybridization (FISH) emerged as a novel and highly advanced diagnostic breakthrough. By visualizing gene amplifications like HER2, FISH allowed clinicians to look deeper into the cell’s morphology—linking visual structure with genetic behaviour and improving accuracy in diagnosis and treatment planning. Over time, this was complemented by other innovative molecular technologies such as Real-Time PCR, MLPA (Multiplex Ligation-dependent Probe Amplification), and Next-Generation Sequencing (NGS), which detect genetic mutations including BRCA1, BRCA2, and TP53—critical for assessing hereditary risk and enabling early intervention.
Kandhari says that the importance of hereditary screening came into global spotlight when actor Angelina Jolie publicly shared her decision to undergo preventive surgery after learning she carried a “faulty” BRCA1 gene, which sharply increased her risk of developing breast and ovarian cancer. Her story underscored the life-saving potential of genetic testing and encouraged women worldwide to be proactive about early detection and screening.
A crucial factor that has empowered the medical fraternity across the world to understand the disease better and reduce mortality rates drastically is the sharing of knowledge through training programs and workshops.
“One of the biggest challenges in breast cancer detection in India remains the limited adoption of regular health check-ups and delayed medical attention at the first signs of symptoms. While awareness has improved over the years, the scale of our population and the rising incidence of breast cancer highlight an urgent need for stronger public focus on preventive healthcare and early diagnosis. An initiative like marking October as the ‘Breast Cancer Awareness’ month will ensure that more people break away from the taboos and fears associated with the disease and get themselves checked regularly so that timely detection through the plethora of advanced technologies can save their lives,” Kandhari concludes.
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