Article Topic: Breast Imaging

New imaging approach reduces unnecessary breast biopsies by nearly 25%

WashU researchers at Siteman Cancer Center are advancing breast imaging to help patients avoid invasive procedures and improve the screening experience

In a new discovery at Siteman Cancer Center at Barnes-Jewish Hospital and WashU Medicine, a team of researchers and physicians found that utilizing ultrasound-guided diffuse optical tomography technology can reduce unnecessary breast biopsy rates by nearly 25%.

Now for the first time in a clinical trial, Siteman Cancer Center is using these new methods first, rather than starting with a biopsy, to determine if additional diagnoses are needed to test for cancer. The research was recently published in Breast Cancer Research and supported by a nearly $2 million grant from the National Cancer Institute of the National Institutes of Health.

Every year in the United States, more than 1 million breast biopsies are performed. Yet 75-80% of those biopsies turn out to be benign, meaning patients undergo an invasive procedure, anxiety, and waiting — only to learn cancer is not present.

New Research in Breast Cancer Imaging

In a double-blind clinical trial involving 226 patients, the WashU Medicine research and physician team at Siteman found that ultrasound-guided diffuse optical tomography (DOT) — used alongside standard breast ultrasound — can reduce unnecessary benign biopsies by nearly 25%, while maintaining a false negative rate below 2%, consistent with American College of Radiology safety standards.

By combining standard ultrasound with diffuse optical tomography, radiologists gain additional information about tissue biology, not just structure.

Why This Matters for Patients Undergoing Breast Imaging

A biopsy remains the only way to definitively diagnose breast cancer. However, many suspicious findings on mammography or ultrasound are not cancer — and the uncertainty between imaging and biopsy can be one of the most stressful periods in a patient’s experience.

This research aims to improve how physicians distinguish which lesions truly require biopsy and which may be safely monitored. For patients, it means care that is not only the most advanced but thoughtfully designed to ensure that cancer is detected as early and screening is as accessible and low-cost as possible for more people.

Leadership in Breast Imaging Innovation

The study was led by:

Their multidisciplinary team included experts in radiology, pathology, engineering and clinical research across Siteman and WashU:

The study team also included Steven P. Poplack, MD, formerly of WashU Medicine and Siteman, who is now a professor of radiology (breast imaging) at Stanford University.

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Zhu Q, Bennett D, Hagemann IS, Mannix J, Wiele K, Luther M, Luo J, Poplack SP. Ultrasound-guided diffuse optical tomography: An adjunct to ultrasound that can reduce unnecessary breast biopsies. Breast Cancer Research, published online Dec. 31, 2025. DOI: https://doi.org/10.1186/s13058-025-02206-3



Funding for this research was provided by the National Cancer Institute of the National Institutes of Health (R01CA228047).

Bennett named Evens Professor of Women’s Health

WashU Medicine breast cancer imaging specialist Debbie L. Bennett, MD, chief of breast imaging at Mallinckrodt Institute of Radiology (MIR), was installed Aug. 14 as the Ronald and Hanna Evens Endowed Chair in Women’s Health at Barnes-Jewish Hospital.

Bennett oversees screening and diagnostic mammography services at Siteman Cancer Center, based at WashU Medicine and Barnes-Jewish Hospital, and is a member of the breast cancer specialist team. As a member of several national panels, she is helping shape national guidelines and policies relating to breast imaging and cancer screening. She is also a co-author on the most recent version of the ACR Breast Imaging Reporting and Data System Atlas, the international standard for breast imaging reporting. Bennett was named chief of breast imaging in 2020.

“We’re forging history and moving forward with new techniques that support women,” said Pamela K. Woodard, MD, the Elizabeth E. Mallinckrodt Professor of Radiology and director of MIR. “Debbie has been a mentor to many residents who have chosen breast imaging as their career.”

A physician committed to providing high-quality care throughout the community, Bennett specializes in the diagnosis of benign breast conditions and breast cancer. Her research focuses on the early diagnosis of breast cancer and the impact of screening mammography on population outcomes, and she is a co-investigator on multiple collaborative research projects focused on mammogram-based risk prediction, risk reduction interventions and use of novel technologies to reduce benign biopsies.

At her installation ceremony, Bennett presented “Building Community Through Breast Imaging,” in which she discussed the evolution of MIR’s breast imaging section. “This is the house that Barbara built,” she said, referring to Barbara Monsees, MD, professor emeritus of radiology, who was the first chief of breast imaging and later the inaugural Ronald and Hanna Evens Endowed Professor of Women’s Health. The impact of her decades-long career is still felt today, with accomplishments including co-developing the Joanne Knight Breast Health Center and launching the mammography van in 1986 — bringing breast cancer screening to underserved areas across the region.

Established in 2004 by The Foundation for Barnes-Jewish Hospital, the Ronald and Hanna Evens Endowed Chair in Women’s Health honors the distinguished career of Ronald Evens, MD, longtime MIR director who oversaw a time of booming growth for the department. He held many other leadership roles, including president and CEO of St. Louis Children’s Hospital, president of Barnes-Jewish Hospital, vice chancellor for financial affairs at WashU and vice president of Washington University Medical Center. Hanna Evens is a 1960 graduate of Barnes Hospital School of Nursing and a former nurse at St. Louis Children’s Hospital.

Bennett was installed in a ceremony held at WashU Medicine. She punctuated the night with the nexus of her medical philosophy: “Always bring it back to the patient.”