Advancing breast cancer diagnosis in 3D: The transformative power of X-ray phase-contrast microtomography for virtual histology

Breast cancer, a prevalent global malignancy in women, demands accurate tissue alteration detection for effective diagnosis and treatment. Histology, pivotal in diagnosis, faces challenges like time, limited tissue, and lacking comprehensive three-dimensional views. This review explores X-ray microtomography virtual histology as a complementary tool to address histology's limitations. Particularly, phase-contrast techniques offer non-destructive, high-resolution 3D imaging, surpassing traditional histology constraints. Phase-contrast microtomography provides valuable insights into breast tissue alterations, aiding early cancer detection and enhancing diagnostic precision. The role of synchrotron facilities and alternative validation approaches for clinical settings are discussed. Another significant aspect covered in this review is the global shortage of pathologists, which poses a major challenge in the timely and accurate diagnosis of breast cancer. Phase-contrast microtomography can support pathologists by offering digital imaging capabilities, which enable remote consultation and reduce the dependency on physical tissue sections. •Phase-Contrast μCT complements histology, offering 3D tissue insights.•Virtual histology images may complement current histology procedures.•The improved differentiation between structures and lesions could be beneficial for the clinic.•Virtual histology can mitigate the worldwide shortage of pathologists.