Microwave-induced thermoacoustic (TA) imaging (MTAI) is a promising alternative to biomedical imaging due to its high resolution, deep imaging depth, and minimal biohazard. To provide images of different anatomical regions and apply them to different clinical scenarios, the development of miniaturized portable TA probes is imperative. This study is aimed to propose a highly efficient handheld non-reflective microwave-acoustic coaxial TA probe to advance the translation of MTAI for the clinical use. The TA probe integrates a hollowed microwave antenna with a forward radiating uniform microwave field and a linear ultrasonic transducer array which is placed in the hole in the middle of the antenna that has almost no effect on the microwave distribution. The integrated probe was evaluated for properties, including the excitation efficiency of the microwave and the reception efficiency of the acoustic signal. Finally, an isolated EMT6 cell tumor was embedded in a sheep mammary gland to simulate the natural breast tumor environment, and the tumor was detected with the proposed MTAI probe to evaluate its practical feasibility. Compared with the previous TA imaging probe, it has improved the detection efficiency of TA signals by up to 41%, contributing to an improved signal-to-noise ratio (SNR) of the image. The proposed TA probe successfully detected tumors embedded in the breast with a contrast ratio 3.27 times higher than the surrounding tissue in phantom experiments. The proposed TA probe with the features of microwave illumination and ultrasonic detection of coaxial, avoiding TA signal attenuation due to reflection, enables high-efficient TA signal excitation and detection. The proposed TA probe is essential for improving the excitation and detection efficiency of TA signals, and increasing the flexibility of the probe, providing a bright future for the clinical application of MTAI technology.