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Breast cancer often necessitates surgical interventions such as breast-conserving surgery or mastectomy. In these surgeries, sentinel lymph node (SLN) samples are often excised for histopathological examination to ascertain the presence of cancer metastasis. Despite its importance, traditional hematoxylin and eosin (H&E) staining, considerably prolongs the operation because of its complex processing requirements. Ultraviolet photoacoustic microscopy (UV-PAM) has emerged as a solution for bypassing the necessity of tissue staining or sectioning. However, its clinical application has been hindered by imaging speed. To overcome this challenge, we have developed a fast-scanning, reflection-mode UV-PAM designed for histopathology without staining based on high-sensitivity, wide-vision optical ultrasound detection. A specimen area of around 12 mm² can be scanned in 8 min with a lateral resolution of 1.5 μm. To enhance imaging speed, multi-focal PAM was implemented, resulting in a fourfold acceleration. This PAM technique has been utilized in SLN biopsy to differentiate cancerous tissue in breast cancer patients.