Routine Gynecologic Care

Breast cancer is one of the most significant public health concerns in the world. In the U.S. alone, an estimated 316,950 new cases of invasive breast cancer are expected to be diagnosed in women in 2025. Early detection continues to be a monumental factor in improving survival rates and reducing the severity of treatment needed. To catch breast cancer in its earliest stages, a range of screening tools are used, most commonly a mammogram and clinical breast exams (CBEs).

While the mammogram is regarded as the gold standard in early detection, the clinical breast exam remains a valuable part of any exhaustive screening approach. Let’s look at why CBEs still matter, especially when used alongside mammograms in an ongoing effort to detect breast cancer early.

The Role of Mammograms in Breast Cancer Screening

Mammograms are a type of X-ray imaging of the breast that is used to detect early breast cancer, typically before symptoms appear. They are considered the cornerstone of routine breast cancer screening and have been instrumental in reducing mortality rates through early detection.

During a mammogram, the breasts are compressed between plates while a low-dose X-ray captures images from different angles. These images allow radiologists to identify abnormal areas that may indicate cancer, such as masses or macrocalcifications.

Benefits of mammography include:

• Early Detection – Mammograms can identify tumors that are too tiny to be physically felt during an exam, allowing for intervention at an earlier and more treatable stage.
• Improved Outcomes – Regular mammogram screenings yield a mortality reduction of 40 percent in women ages 40 to 84 compared to no screening.
• Long-Term Monitoring – Mammograms provide a baseline that can be used to track ongoing changes in breast tissue.

Despite their benefits, mammograms are not infallible. False positives are possible, resulting in unneeded stress and extra tests. False negatives can also occur, especially in women with dense breast tissue, as these abnormalities can be more difficult to detect.

Mammograms also do not replace the need for a physical assessment, especially when patients present with symptoms such as lumps or changes in breast appearance.

Clinical Breast Exams and Why They Matter

While mammograms are a powerful tool in breast cancer detection, they are not the only method that should be relied upon. Clinical breast exams are hands-on examinations of the breasts performed by a health provider. These exams offer a valuable and complementary approach to detecting issues that mammograms might miss.

A clinical breast exam involves a trained medical professional systematically checking the breasts and underarm area for lumps, irregularities, skin changes, or other signs of concern.

It typically takes just a few minutes and is often done during an annual physical or gynecological visit. During the exam, the provider also assesses the size, shape, and texture of any abnormalities to determine whether further testing is needed.

There are several reasons why CBEs still matter:

1. Detection Beyond Imaging

Mammograms can sometimes miss cancers, especially in women with dense breast tissue. A clinical exam can catch palpable lumps or changes that may not yet be visible on imaging.

2. More Personalized Evaluation

Unlike imaging, which provides a snapshot, a CBE allows for real-time feedback and patient-provider dialogue. This can help uncover symptoms such as tenderness, nipple discharge, or recent changes that a machine cannot detect.

3. Improved Access in Underserved Areas

In regions with limited access to mammography, clinical breast exams may be the only practical screening tool available. While not a substitute for mammograms, CBEs can still lead to early detection and prompt referral for imaging when needed.

4. Early Identification of Non-Cancerous Conditions

Many benign breast conditions, such as cysts or infections, can cause concern or discomfort. Clinical exams help diagnose and manage these issues, providing reassurance or guiding treatment.

Complementary Roles of CBEs and Mammograms

Clinical breast exams and mammograms are most effective when used together as part of an extensive breast cancer screening strategy. While mammograms excel at detecting abnormalities that are not yet palpable, they can occasionally miss certain types of tumors, particularly in women with dense breast tissue.

This is where CBEs provide critical support, allowing trained professionals to detect lumps or changes that might not appear on imaging. Using both tools increases the chances of early detection, which is important for more effective treatment outcomes.

For example, a woman might present with a lump that is felt during a CBE but not visible on a mammogram, prompting further evaluation, such as an ultrasound or biopsy. Conversely, a mammogram might reveal a suspicious area long before it’s detectable by touch.

Stay on Top of Your Breast Care with Help from Raleigh Gynecology and Wellness

Early detection saves lives, and combining clinical breast exams with mammograms offers the most thorough approach to breast health. At Raleigh Gynecology and Wellness, we offer personalized and compassionate care so you can stay on top of your breast health. Contact us today to schedule your next clinical breast exam and mammogram to maintain your breast health.

For many women, heavy periods and intense cramps are more than just a monthly disruption. They can be physically painful, affect emotional well-being, and impact overall health. If you’ve ever found yourself planning your week around your period due to the anticipated discomfort, you’re not alone.

As many as 5 to 10 percent of women say their period pain is so severe it disrupts their life. While every woman’s body is different, birth control is often effective in providing relief from heavy periods and cramps. Find out how your contraceptive care can double as powerful support for heavy periods and painful cramps.

Causes of Heavy Periods and Menstrual Cramps

Heavy periods, also known as menorrhagia, occur when bleeding lasts longer than seven days or requires changing a pad or tampon every one to two hours. This level of blood loss can lead to fatigue, discomfort, and possible anemia.

Menstrual cramps often accompany heavy periods but can also occur in women with light and/or short periods. Called dysmenorrhea, this common side effect can cause pain in the lower abdomen and lower back that can radiate down the legs.

Primary dysmenorrhea refers to cramping that occurs without an underlying medical condition, while secondary dysmenorrhea is typically linked to another health problem, such as uterine fibroids or endometriosis.

How Birth Control Can Help Manage Symptoms

Hormonal birth control can be an effective tool in managing heavy periods and painful cramps. Adjusting the body’s natural hormone levels can help regulate menstrual cycles, reduce the thickness of the uterine lining, and lessen the strength of uterine contractions.

These changes can lead to lighter, shorter periods, and milder cramping, making a significant difference in your daily comfort and quality of life.

Birth Control Options that Can Alleviate Heavy Periods and Cramps

Some of the most common birth control options that have been found effective in managing heavy periods and cramps include:

Birth Control Pills

Combination birth control pills, which contain both estrogen and progestin, are often prescribed to help regulate periods and reduce cramping. They not only shorten the length and intensity of bleeding but also create more predictable cycles. Progestin-only pills can also provide some relief and can be a safer option for certain women as they don’t contain estrogen.

IUDs

Hormonal intrauterine devices (IUDs), such as Liletta, Kyleena, Skyla, and Mirena, are highly effective at reducing heavy menstrual bleeding and cramping. These small, T-shaped devices release a low dose of progestin directly into the uterus, thinning the uterine lining and often minimizing or even eliminating periods over time. The copper IUD (Paragard) should be avoided as it can actually make periods heavier.

Implants

A contraceptive implant, such as Nexplanon, is a small rod inserted under the skin of the upper arm. Once in place, the device steadily releases progestin into the body, often resulting in lighter periods or periods that stop altogether. This long-acting reversible contraceptive method can last up to three years and has a failure rate of just 0.01 percent.

Injections

The Depo-Provera shot is another popular birth control option that can help control heavy periods and cramping. The shot is administered every three months and works by suppressing ovulation and thinning the uterine lining.

Some women who get birth control injections will stop having periods altogether. What makes the Depo-Provera shot so popular is its convenience. You don’t need to remember to take a pill and when used correctly, it can be very effective at preventing pregnancy.

Patches

The birth control patch works similarly to birth control pills by delivering hormones through the skin. When used consistently, it can regulate menstrual cycles, decrease bleeding, and lessen cramping, offering a convenient alternative for those who prefer a non-daily method. Generally a new contraceptive patch should be applied to the body once a week, for three weeks. The patch should be skipped on the fourth week when you’d have your period.

Contraceptive Rings

Much like Birth control pills and patches, vaginal contraceptive rings use estrogen and progesterone to suppress ovulation and control menstrual bleeding. Typically the rings is placed in the vagina for 3 weeks and then removed for a week.

What to Consider Before Going on Birth Control

Before starting birth control to manage heavy periods and cramps, considering your overall health and lifestyle is important. Some birth control methods may be better suited for certain medical conditions, while others could carry side effects that don’t align with your personal preferences or health situation.

Also, consider whether you want a daily method, such as a combination pill, or a longer-term option, such as an implant or IUD. Talk with your healthcare provider who can help you weigh the benefits and potential risks to find a method that best supports your body, personal needs, and future plans.

Schedule an Appointment with Raleigh Gynecology and Wellness Today

Heavy periods and painful cramps don’t have to be something that you simply endure month after month. Birth control offers a safe and effective way to manage these symptoms. If you’re ready to learn how contraceptive care can improve your quality of life, contact Raleigh Gynecology & Wellness today to schedule an appointment. Our all-women team is here to support you and provide a comfortable environment to help address your specific needs.

Getting a call back after a routine mammogram can be concerning, especially if the phone call was preceded by unusual symptoms. If this happens to you, don’t panic. According to the American Cancer Society, fewer than 1 in 10 women called back for additional mammography testing are diagnosed with cancer.

However, if you are scheduled for more imaging, knowing what to expect can help you understand why you may be called back and how you can prepare for your upcoming visit.

Call-Back Reasons After a Mammogram

If you’ve recently had a mammogram, and your provider’s office called you back for a breast ultrasound, breast MRI, or other additional testing, know that this is a fairly common occurrence. Call-backs after a routine mammogram can happen for a variety of reasons unrelated to breast cancer.

Some reasons for a mammogram results call-back include:

• Dense Breast Tissue – If you’re like many women, you may have dense breasts. Breast tissue is made up of various components, including fibrous tissue, glandular tissue, and ducts. Fibrous tissue and fat give breasts their shape, while glandular tissue is responsible for producing milk. Women with more fibrous or glandular tissue are considered to have dense breasts, which can interfere with reading mammograms.
• Unclear Imaging – Many photos are taken of the breasts during a mammogram. However, not all photos may be clear or may not capture all of the tissue. When this happens, the risk of a missed diagnosis is significantly increased and your provider may want a more accurate reading, prompting a call-back for additional imaging.
• Area of Concern – Sometimes imaging will come back with spots that may not necessarily be cancer-related but are areas of concern. For example, a mammogram may show what appears to be a mass, cyst, or calcification. While many of these areas of concern turn out to be benign, your provider will want to check to make sure that the mass doesn’t need to be removed.

Getting a call-back after a first-time mammogram is more common, as providers have no other imaging to compare the results to, leaving more room for interpretation. Call-backs after imaging are also more common in women who have not yet gone through menopause.

What to Expect If You Need Additional Imaging

If you are called back for additional imaging after a mammogram, your provider may recommend a variety of tests based on your specific needs. The most common types of tests used for this purpose are diagnostic mammograms, breast ultrasounds, and breast MRIs.

Diagnostic mammograms are similar to routine mammograms but are used to look at specific areas of concern in the breast tissue. During the test, your provider will take images of these areas and send them to a radiologist who will interpret them. Special instructions are provided to review the area of concern and determine if the problem is benign or if additional testing is needed.

Breast ultrasounds are often recommended after a call-back when the provider needs to differentiate between potentially cancerous masses and non-cancerous substances, such as cysts. This non-invasive test uses sound waves to generate images that show subtle differences between the two.

Women who are considered high risk for breast cancer may require a breast MRI in addition to a mammogram. MRIs use powerful magnets to generate detailed images of the breasts. When reviewed by a radiologist, these images can often help providers get a more accurate diagnosis.

When mammogram findings are deemed suspicious, your provider may suggest a biopsy to get a closer look at the area of concern. This procedure involves placing a thin needle into the mass to collect samples. The tissue samples are then sent to a laboratory where a pathologist will review them and determine if additional follow-up testing is needed.

Catching Breast Cancer Through Early Detection

One of the best ways to catch breast cancer in its earliest stages is with the proper technology. exam 3D Mammography offers the latest breast cancer screening technology with more accurate results compared to traditional 2D mammograms. When performed by a trusted professional, 3D Mammography the Geniuscan find 20 to 65 percent more invasive breast cancers.

The steps of the procedure are very similar to a traditional mammogram. Your breasts will be positioned in the machine with compression applied to get clear images. During the test, an X-ray arm sweeps over the breast and takes multiple images each second. A technologist will then review the images and a Radiologist will read the mammogram before giving you your results.

Rely on Raleigh Gynecology & Wellness for Your Breast Health

Requiring additional testing after a mammogram is not unusual, but taking the situation seriously is important. If you’re concerned about the outcome of your latest mammogram or have questions about what you can expect at your next appointment, contact our team at Raleigh Gynecology & Wellness at (919) 525-3959.

Our all-women team offers compassionate care to make you feel comfortable during each visit and confident that your health is in good hands.

It can be nerve-wracking to discover that the results of your latest mammogram were abnormal, prompting a visit for additional testing. However, an abnormality found in your results doesn’t necessarily mean that you have breast cancer. While mammography technology has come a long way over the last decade, it is not impervious to mistakes.

In the U.S., about 10 percent of mammograms result in call-backs for further testing. However, of these mammograms, just 7 percent lead to a cancer diagnosis. If your recent mammogram detected an abnormality, here’s what you need to know.

Understand Your Mammogram Report

Knowing how to read your mammogram report is important for better understanding what your results actually mean. When the results of a mammogram are analyzed and reported, the radiologist will categorize the results based on a standard numbered system. The system, known as the Breast Imaging Reporting and Data System (BI-RADS), categorizes mammography results based on numbers 0 to 6.

Category 0 – Incomplete

A result of category 0 means that the radiologist may have detected what they expect to be an abnormality, but the results were not clear, and additional imaging is needed for a more accurate diagnosis.

Category 1 – Negative

This is considered a normal test result, meaning the breasts appear symmetrical with no distorted structures, masses, or suspicious calcifications.

Category 2 – Benign Finding

A benign, non-cancerous, finding is considered a negative test result. The radiologist may have found a benign calcification, lymph node, or mass in the breast that is not cancer.

Category 3 – Likely Benign Finding

Findings in this category indicate a benign discovery, typically with a less than 2 percent chance of it being cancer.

Category 4 – Suspicious Abnormality

While these findings do not always result in a breast cancer diagnosis, suspicion will often dictate the need for a biopsy. Findings in this category are further broken down based on the likelihood of cancer, ranging from low likelihood to high likelihood.

Category 5 – Highly Suggestive of Malignancy

If you get a Category 5 result, appropriate action should be immediately taken. The findings will typically look like cancer and have a high chance of cancer, usually at least 95 percent. With this result, a biopsy is strongly recommended.

Category 6 – Proven Malignancy

A Category 6 result is generally reserved for findings on imaging that have already proven to be cancer from a previous biopsy. Immediate action should be taken to determine the best course of action, and additional imaging may be used to see how the cancer responds to treatment.

What to Expect at Your Follow-Up Appointment

If you received an abnormal result on your mammogram, you’ll likely be asked to come in for a follow-up appointment. The type of additional testing recommended to you by your provider will depend on the categorization of your test results, the density of your breast tissue, and other relevant factors.

A diagnostic mammogram may be recommended to get more accurate photos of the areas of concern. This imaging is similar to a routine mammogram but focuses on the mass or other abnormality seen in the previous tests. A radiologist will then be contacted to review the new images.

If more detailed imaging is needed after receiving abnormal results on a mammogram, a breast ultrasound or breast MRI may be recommended. An ultrasound of the breast uses sound waves to generate pictures of the inside breast tissues and structures.

This non-invasive procedure can be useful for differentiating between fluid-filled masses, such as benign cysts, and solid masses, which could indicate cancer. A breast MRI may be recommended for women at high risk for breast cancer or to evaluate the extent of breast cancer after a diagnosis.

During this procedure, you’ll lie face down on a padded table with your breasts positioned in the appropriate openings. The table is then slid into an MRI machine where detailed images are taken using radio waves and magnets. A contrast agent may be injected to achieve better visualization.

In some cases, you may need a biopsy to check for cancer. This procedure involves removing a small piece of the tissue to be examined under a microscope. Several different types of biopsies exist, such as those done with a small, hollow needle and those completed through a small cut in the skin.

Call Raleigh Gynecology & Wellness for Breast Care

Choosing the right technology and the right care provider when approaching breast cancer can make all the difference in your health outcome. At Raleigh Gynecology & Wellness, we offer the latest advancements in breast cancer screening.

Genius 3D Mammography exams can find 20 to 65 percent more invasive breast cancers compared to traditional 2D mammograms. Contact our office today to learn more about this exam or to discuss any concerns you may have about your breast health.