Existing mammographic screening solutions are generally associated with several major drawbacks, such as exposure to ionizing radiation or insufficient sensitivity in younger populations with radiographically-dense breast. Even when combined with ultrasound or magnetic resonance imaging, X-Ray mammography may still attain unspecific or false positive results. Thus, development of new breast imaging tools represents a timely medical challenge. We report on a new approach to high-resolution functional and anatomical breast angiography using volumetric hand-held optoacoustic tomography, which employs light intensities safe for human use. Experiments in young healthy volunteers with fibroglandular-dominated dense breasts revealed the feasibility of rendering three-dimensional images representing vascular anatomy and functional blood oxygenation parameters at video rate. Sufficient contrast was achieved at depths beyond 2 cm within dense breasts without compromising the real-time imaging performance. The suggested solution may thus find applicability as a standalone or supplemental screening tool for early detection and follow-up of carcinomas in radiographically-dense breasts. Volumetric handheld optoacoustic tomography scanner uses safe pulses of near-infrared light to render three-dimensional images of deep vascular anatomy, blood oxygenation and breast parenchyma at video rate.