Journal of Engineering Research and Education Volume 10, 2018 [57-72] Image Processing in Breast Carcinoma Histopathological Image: A Review Tan Xiao Jian 1* , Nazahah Mustafa 1 , Mohd Yusoff Mashor 1 and Khairul Shakir Ab Rahman 2 1 School of Mechatronic Engineering, University Malaysia Perlis, 02600 Arau, Perlis, Malaysia. 2 Hospital Tuanku Fauziah, 01000 Kangar, Perlis, Malaysia. ABSTRACT Breast carcinoma grading of histopathological images is the standard clinical practice for the prognosis and diagnosis of breast carcinoma development. The grading provides semi- quantitative assessment for mitotic activity, tubules formation and nucleus pleomorphism. Semi-quantitative scores obtained from the manual grading are inconsistent and may lead to inter- and intra- raters variability. Fortunately, the recent advances in image processing have significantly increased the possibility of fully quantifying the breast carcinoma features, reducing workload of pathologist and providing reproducible and high accuracy results. This paper is meant as an introduction for non-experts. It starts with an overview of the breast carcinoma, breast carcinoma grading systems and followed by a discussion on different image processing techniques applied to measure tubules formation, nucleus pleomorphism and mitotic activity as well as a discussion on complete system for the breast carcinoma measurement. Keywords: Biomedical Engineering, Image Processing, Breast Carcinoma, Nottingham Grading System, Quantitative Measurement. 1. INTRODUCTION Breast carcinoma represents a huge global health problem among women in both developed and developing countries. It is estimated that over 508,000 women worldwide died in 2011 due to breast carcinoma [1]. The WHO statistics showed that 50% of breast carcinoma cases and 58% of the deaths occurred in the developing countries such as Malaysia, Indonesia and Thailand [1]. The incidence rates of breast carcinoma vary greatly worldwide from 19.3 per 100,000 women in Eastern Africa to 89.7 per 100,000 women in Western Europe. In developing countries, the incidence rates are below 40 per 100,000 cases [1]. African countries found to be the lowest incidence rates across the globe. The survival rates of breast carcinoma vary greatly worldwide, ranging from more than 80% in Sweden, Japan and North America to around 60% in the middle-income countries and below 40% in the low-income countries [1]. A recent study found that Malaysian women are prone to a high risk in developing breast carcinoma during their lifetime: 1 in 28 women [2]. The incidence rates are higher in the urban areas: 1 in 22 women, as compared to the rural areas: 1 in 60 women [2]. Some states in Malaysia were reported to have higher breast carcinoma incidences. Penang, Kuala Lumpur and Johor are the top three states with Age-standardised rate (ASR): 50.0, 42.2 and 39.8 incidences per 100,000 people, respectively. Breast carcinoma has been found to be the top cancer that commonly develops in women during their lifetime: 32.1%. The incidence cases of breast carcinoma in Malaysia have increased since 2007. There were 3579 positive cases reported in * Corresponding Author: xj_0506@gmail.com