About 80% of breast cancer biopsies are benign, and combined ultrasound-DOT imaging could reduce unnecessary biopsies.

About 80% of breast biopsies in the U.S. are benign; a study of 226 patients found that adding diffuse optical tomography (DOT) to ultrasound reduced biopsies of benign lumps by about 25% and had a 1.8% false-negative rate.

Ultrasound is commonly used when doctors evaluate breast lumps, but it cannot always tell whether a solid mass is benign or cancerous. In the United States, more than 1 million breast biopsies are performed each year and about 80% of them are benign, which can lead to anxiety, procedure-related complications and added costs. Diffuse optical tomography (DOT) uses near-infrared light to measure blood hemoglobin concentration and oxygen levels in tissue without requiring injected contrast agents. Researchers report that combining a hand-held DOT system with ultrasound provides both structural and functional information about lumps and may improve diagnostic accuracy. Key findings: - The study imaged 226 patients who had been recommended for routine breast biopsy and used combined hand-held ultrasound and DOT; final diagnoses were confirmed by biopsy. - Radiologists and engineers were blinded to biopsy results when they reviewed standard imaging and then DOT measurements. - Cancerous lesions showed higher total hemoglobin concentration and lower oxygen levels compared with benign lumps, with more aggressive cancers showing larger differences. - When radiologists reviewed DOT data in addition to standard imaging, biopsies of benign lumps decreased by about 25%. - The study reported a 1.8% false-negative rate when DOT information was used, a rate the authors note aligns with guidelines that support monitoring rather than immediate biopsy in some cases. Summary: The combined ultrasound-DOT approach added functional biomarkers — blood and oxygen measures — to standard imaging and was associated with fewer biopsies of benign lumps in this study population. Researchers say the technology is being refined and that teams are exploring incorporation of AI and evaluation alongside other imaging methods; DOT combined with mammography or MRI may be harder to use routinely in clinics. Further studies and technical development were described as priorities by the team.