A cancer scare for Bailey Renger served as the spark for her founding and helming BeSound, a modern breast imaging company that helps find what mammograms can miss and is focused on improving detection for women underserved by today’s screening options, particularly those with dense breasts and women under 40.
“We believe it’s a scalable solution for women with dense breast tissue, women at intermediate risk, and younger women,” she says.
You can hear more from Renger from her presentation at DOC 2025’s “The Great Healthcare Correction: Women’s Health” session in the video below or read her lightly edited transcript.
TRANSCRIPT:
Bailey Renger
Hi everyone. I’m Bailey, and a physicist by training, so my background is actually in quantum computing. I worked at NASA and Harvard and started my PhD in physics at Brown, and I’m currently on leave to build this company. After my own cancer scare, I realized that this is a huge problem and I felt a sense of urgency. Here I am.
Breast cancer screening today is failing women really in two main ways. The technology, but then also the system and the access to that technology. You’ve all probably heard of dense breast tissue. Maybe most of you women in the room have dense breast tissue. The reality is, if you have dense breasts, your breast cancer can be missed on a mammogram alone. In fact, 40% of breast cancers are missed by mammography alone. We’re underserving women with dense breast tissue, but then also women under 40, which flash, if you’re under 40, you can get breast cancer. The rates are actually skyrocketing in women under 40, which is very concerning. But there’s no way to get screening reimbursed, so we’re also serving that group of women. Then, the emotional stress that comes with waiting weeks to get a diagnosis, we aim to solve that through technology, the AI that we’re building, which we really excited about.
I love this image because it’s a really great visual on what does dense breast tissue look like. From left to right, you can see these are four different mammograms of women with increasing breast density. You can see that dense breast tissue shows up as the color white. So does breast cancer. This is a physics problem. It’s just difficult. There’s a masking effect. So it’s difficult for radiologists to actually discern whether or not breast cancer is present. Another fact about having dense breast tissue is you’re actually at an increased risk of breast cancer. We’re doubly failing these women. You’re more likely to have breast cancer and you’re more likely to have it missed.
You can only determine breast density through medical imaging. You can’t tell by looking at a breast. You can’t tell by the size of your breast. It’s post mammogram or MRI. There’s really a tailwind right now, which is the FDA updating its guidelines around notification of breast density.
This happened last fall, and so now women are required to be notified of their breast density status and that mammograms can miss their breast cancer. So what’s next. 40 million women in the US alone have dense breast. This is just 40 plus. There’s a lot of women under 40 who have dense breast tissue, and a lot of them don’t really know what to do next. It’s not reimbursed in most states. We have a solution that we’re really excited about.
Just to double click on the current breast imaging technologies, what exists today and the sensitivity and specificity and where we’re seeing problems. So screening mammography I mentioned has a low sensitivity. In women with dense breast tissue, and also is not something that’s reimbursed for younger women. It’s not recommended for younger women because there is radiation involved. So exposure to that is also concerning. Screening breast ultrasound is a great adjunct tool for women with dense breast tissue. However, it’s not reimbursed in most states, as I mentioned. Even though it can detect more breast cancers when paired with mammography, it decreases specificity. You might be flagged for having a lesion that, is actually just assessed for fiber adenoma, and, there’s a staggering statistic around here, which is that 80% of breast biopsies are benign. So this is not scalable. We can’t have all these 40 million women now getting a breast ultrasound, and then a lot of them have to get a breast biopsy. It would flood the system. We’re in need of both a technology that can improve the sensitivity of breast cancer screening and the specificity. We also have a solution here, which is, ultrasound-based.
It’s photoacoustic imaging, and this has been demonstrated to reduce false positives and the way that it works is, it’s an ultrasound transducer, and there is near-infrared laser. It’s a dual wavelength probe. Because oxygenated hemoglobin and deoxygenated hemoglobin have unique absorption coefficients, the result is actually this color map overlay. In this color map overlay gives the radiologists information on oxygenation and vascular parity. Functional information. You can think of like a contrast-enhanced MRI except to contrast-enhanced ultrasound. No gadolinium is required. No injections with contrast using light. Functional MRI in a way that’s kind of an analog. On the top row you can see this is a benign lesion. The bottom is malignant. Pink and red indicate regions of hypoxia or that are de-oxygenated. The radiologist can then make the decision to, downgrade or upgrade the lesion based on that data. This is the technology that we are hoping to use diagnostically to help reduce false positive breast biopsies while at the same time, both increasing and then maintaining sensitivity so less cancers are missed.
This is just an overview of there’s a lot of different technologies in this space. We believe that we have found the solution for both best sensitivity and specificity. Contrast enhance MRI is great. However, not very many women can afford that technology or opt out of it because it requires an injection or intravenous contrast and, or they’re claustrophobic. This technology is not painful. No injection is required. We believe it’s a scalable solution for women with dense breast tissue, women at intermediate risk, and then younger women. As I also mentioned at the beginning, we’re building AI to help radiologists read these images more quickly. Acting as a decision support tool so we can drive down the cost of this technology to make it more accessible to more women.