From Technological Innovation to Clinical Adoption: Is Microwave Breast Imaging Ready for Sustainable and Equitable Breast Cancer Detection

Abstract

Microwave Breast Imaging (MBI) is emerging as a non-ionizing imaging modality for breast cancer detection by exploiting dielectric-property differences between healthy and malignant tissues. Although substantial advances in antenna engineering, microwave tomography, computational imaging, and artificial intelligence have significantly improved system performance, routine clinical implementation remains limited. Unlike previous reviews that primarily emphasize technological innovation and diagnostic performance, this review critically examines the translational readiness of MBI by integrating technological maturity, clinical validation, regulatory readiness, implementation feasibility, health-economic considerations, sustainability, and health equity. The study adopts a structured critical comparative review of peer-reviewed literature published between 2020 and 2025 to evaluate the current status of clinical translation and identify the factors governing healthcare adoption. The comparative analysis indicates that MBI has progressed from proof-of-concept research to early clinical translation, supported by multicenter clinical investigations, advances in AI-assisted imaging, and growing clinical validation. However, routine adoption remains constrained by limited prospective clinical validation, the absence of standardized evaluation frameworks, insufficient health-economic assessment, incomplete regulatory pathways, and scarce implementation research. Building on these findings, the review identifies a multidimensional translational evidence gap and introduces the Translational Readiness Framework for Microwave Breast Imaging (TRF-MBI) as a conceptual framework for evaluating clinical adoption and guiding future translational research. The review concludes that successful integration of MBI into breast cancer care depends primarily on strengthening clinical, regulatory, economic, and implementation readiness rather than on further technological innovation, thereby supporting sustainable and equitable healthcare delivery