| I put off getting my first mammogram for one, two, then three years, mostly because my family health history didn't suggest an urgent need for one. When I finally went for the first time at 43, it became clear to me why some women might drag their feet for another reason entirely. “This might be a little uncomfortable,” the tech warned right before wedging me into what felt like a massive tortilla press and clamping down — hard. I may or may not have sworn involuntarily as she did this three, four, five times (?!) on each breast. I started to hate this completely nice and totally professional mammography assistant, especially when she told me I’d have to come back in a few days for more images to establish my “baseline.” Part of me still can’t get over that this is the standard experience for women getting screened for breast cancer. But it may not have to be this way, I learned recently. For decades, researchers around the world have been developing a technique that uses light and sound to produce images of the inside of the body. (Its roots go back even farther: Alexander Graham Bell was the first to try to generate sound from light back in 1880.) A team over at the California Institute of Technology has developed a functional photo acoustic tomography system that can scan and image the entire breast in less than 15 seconds. Here’s how it works: The patient lays face down on a table placing one breast at a time into a recess filled with warm water. A scanner below the table sends a short pulse laser light into the tissue where it converts into ultrasonic energy, explains Lihong Wang, a professor of medical engineering and electrical engineering who helms the team at Caltech and is one of the leading researchers in the field of photoacoustics. “We use ultrasound to provide spatial information,” he said, and “we use light to provide molecular information.” An algorithm takes the raw data and turns it into a high-resolution, high-contrast image that, when combined with machine learning, can give radiologists more visibility into suspicious lesions. According to early clinical results Wang and his team published this summer, when they tested the technology on 39 patients, it performed as well as or better than conventional imaging techniques. The results suggest it may be especially promising on dense breast tissue, which can be difficult to image — hence all the squeezing — and often lead to false positives and unnecessary biopsies. The process involves no radiation (unlike X-rays) and no intravenous, heavy metal-based contrast solution (unlike MRIs). And it’s pain-free. The Caltech team needs to test the technology on more patients before it can be commercialized and submitted for clearance to the Food and Drug Administration. The hope is that it could one day replace the traditional mammogram as a regular screening tool. Wang is optimistic about the regulatory side of the equation as the FDA already granted premarket diagnostic clearance several years ago to Seno Medical Instruments, which developed a handheld photoacoustic device that radiologists can use on patients in need of further imaging. Seno's machines are already in place in some hospitals. California-based startup BeSound recently raised $7 million to bring photoacoustic imaging technology direct to consumers beginning in Los Angeles this fall. What’s more concerning in the short term is the research grant outlook: Wang says the award that gave him seven years of funding was eliminated when the Trump administration proposed cutting billions of dollars from the National Institute of Health’s budget, so when it runs out this year, he can’t renew it. His team now will have to spend more time writing grant applications in an environment where researchers are competing for fewer dollars. Without the necessary backing, larger clinical trials would have to wait. “The funding situation is the worst I’ve seen in decades,” he said. — Lindsay Blakely | 
