Breast cancer imaging and neoadjuvant chemotherapy response prediction using the One-Touch Photoacoustic Imaging System

We present the OneTouch breast imaging system, an automated platform that simultaneously acquires co-registered photoacoustic (PA) and ultrasound (US) images of the breast in a standing position. This upright scanning approach aligns with conventional mammography workflows and improves patient comfort while reducing operator variability and exam setup time. The system provides three-dimensional US images of breast morphology and spatially matched PA images highlighting tumor-associated vascular features, without the use of contrast agents or ionizing radiation. In this study, we demonstrate the system’s clinical potential through representative imaging cases from patients with various breast cancer molecular subtypes, including luminal A, luminal B, and triple-negative tumors. These cases show subtype-associated variations in vascular architecture, which may enhance tumor classification beyond conventional imaging. In addition to diagnostic applications, we investigated whether baseline PA imaging could help predict response to neoadjuvant chemotherapy. Among four patients who completed treatment, we found that pre-treatment PA-derived vascular features—specifically endpoint ratio, and maximum branch length—differed between patients who achieved pathological complete response (pCR) and those who did not. These preliminary findings highlight the potential of OneTouch-PAT as a noninvasive tool for breast cancer diagnosis and early response prediction.