Photoacoustic imaging: An emerging tool for intraoperative margin assessment in breast-conserving surgery

Photoacoustic Imaging (PAI) synergizes light's optical contrast with ultrasound's penetration depth via the photoacoustic effect. Breast cancer remains a global challenge, particular demanding precise intraoperative tumor demarcation during breast-conserving surgery (BCS). PAI has the potential to address this need by enabling boundary delineation, promoting complete resection and healthy tissue preservation. This review summarizes breast cancer epidemiology and BCS's clinical demands, highlighting PAI's unique advantages for intraoperative use. PAI can dynamically monitor cellular/tissue morphology, blood oxygen saturation, vasculature, and tumor-associated calcifications, generating high-contrast tumor margin information. This real-time feedback enhances surgical precision, reduces recurrence rates, and improves breast aesthetics and patient quality of life. Despite translational challenges, PAI is poised to become a revolutionary tool for optimizing BCS outcomes.