Routine Gynecologic Care

Breast cancer screening, including mammograms and breast exams with a gynecologist, is an essential part of good healthcare for adults of all backgrounds. However, not everyone attends their regular screenings as recommended by their doctor.

Many factors influence whether someone can undergo regular screening, from financial opportunity to awareness of mammography services in their area.

When an individual cannot access the cancer screening they need, they face an increased risk of more severe types of cancer due to the failure to detect precancerous development early.

This can result in poorer long-term outcomes, greater financial costs, and other negative consequences. If you are facing barriers to breast cancer screening, there are options to help you get the testing you need.

The Problem: Healthcare Coverage

The Affordable Care Act mandated that mammography screening be included with no co-payment; however, not everyone has health insurance.

Data indicate that less than 50% of those who did not have health insurance had a screening mammogram done within the previous two years. This number was slightly higher for those with private health insurance at 80%, but many patients are still not being screened.

The Solution

Patients who lack healthcare coverage have multiple options. The ACA may provide one alternative: subsidies for low-income individuals could cover the cost of nominal health insurance, either in part or in full. Alternatively, some individuals or families may qualify for Medicaid, which typically covers one mammogram per year for those over the age of 40.

The Problem: Awareness

Even among those who have insurance, many do not get regular breast cancer screening because they are not aware of its importance or what role it can play in their health.

Some may assume that breast cancer will show symptoms and that they do not need to worry before then; others (especially men or those with small breasts) may believe that breast cancer is not really a risk for them.

Those who know about breast cancer and the options for screening for it may still lack awareness of local resources that can help.

The Solution

Increasing education for all patients is the first step toward greater awareness of the importance of screening. From quick notes from a primary care doctor to informational pamphlets available at pharmacies, many resources may be available to help people better understand the need for breast cancer screening.

The Problem: Access

Some patients may have the knowledge to understand why screening is important, and it may even be covered by their insurance—but without proper access to screening facilities, these elements do not matter. A person who cannot find public transportation to a clinic or does not have enough sick leave from work might not be able to access screening services, even if they want to.

The Solution

Patients having trouble getting to a screening center might benefit from contacting volunteer organizations in their community. Churches, cancer treatment volunteer groups, and others may be able to provide temporary transportation for those who do not have another option.

In some cases coordinating your mammogram appointment with your routine doctor visit can reduce time away from work and transportation costs. As another line of defense, patients can learn how to do breast self-exams at home.

The Problem: Cultural Differences

America is a melting pot, with an increasing number of residents identifying as belonging to more than one culture. When these other cultures are at odds with how the American medical system conducts screenings, patients may not receive the necessary services.

The most common challenge is language barriers. Patients may not receive helpful education or understand their doctor’s recommendations if they do not share a connection via language—and in some cases, patients struggle to make an appointment at all. In other instances, cultural or religious pressures could prevent patients from seeking medical care from certain providers or offices.

The Solution

Utilize state-provided translation services that are available at many doctors’ offices or research volunteer or non-profit organizations that can provide translation.

Choose medical offices with friendly staff who demonstrate a commitment to patient comfort, including making important information available in a way that makes sense for patients.

Offices with online portals can be beneficial, as they allow patients to review documents in their own time and with the assistance of translation services, knowledgeable family members, and more.

Get Your Breast Cancer Screening as Scheduled to Protect Your Health

Breast cancer screening is an essential service, but many patients do not receive it due to factors ranging from cultural differences to lack of access to being unaware.

Both patients and doctor’s offices can work together to bridge these gaps and make cancer screening accessible for everyone.

The team at Raleigh Gynecology and Wellness champions patient comfort, and we truly strive to get to know all of our patients so that we can communicate with them clearly and completely. Contact Raleigh Gynecology and Wellness to schedule your breast cancer screening.

Many factors contribute to breast cancer risk, from family history to genetic predisposition. However, few people realize that the foods they eat and dietary habits they consider routine may also play a role in their mammography outcomes.

While no superfood prevents breast cancer—nor is there a single food that causes it—a person’s overarching dietary choices influence how the body’s cells grow and divide. A few small changes to your diet can go a long way toward decreasing your risk of breast cancer and enjoying better overall health.

Learn how certain foods and dietary habits can influence breast health and mammogram outcomes so you can make informed decisions about diet, health, and wellness.

Why Fat Is Tied to Cancer

A high-fat diet also tends to be higher in calories, as fat is a calorically dense substance. However, this does not necessarily mean that eating fat is a poor choice; some types of fat, such as mono- and polyunsaturated fats, are good for health and can be found in nutritious items such as avocados and salmon.

The problem with fat arises when a person consumes too many calories, building up excess fat cells in the body. A person who is overweight or obese is typically also at a higher risk of breast cancer due to how fat cells impact hormones. Fat produces estrogen, which is a foundational hormonal component of breast tissue growth.

When the cells in the breasts grow faster and more abundantly, they also replicate faster, which increases the odds that a cell will become abnormal and transition into cancer.

Switching to healthy fats in the diet and avoiding the consumption of excess calories can keep the breast tissue healthy.

The Role of Red Meat

For many years, the adage has spread that red meat is the inferior choice to white meat because red meat causes inflammation. Extensive cohort studies into breast cancer risk have found that while no difference in breast cancer risk was found between groups who ate a high amount of red meat versus a low amount, postmenopausal women did see a higher rate of breast cancer than premenopausal women when both cohorts consumed red meat.

The cause behind this difference is unclear and could range from the cooking method to the type of animal the meat came from.

While the connection between red meat and breast cancer may not be entirely clear, there are still benefits to limiting its consumption. On average, white meat is lower in fat, decreasing caloric consumption.

Other essential nutrients, such as zinc and B vitamins, can be found in white meat, so there is an incentive to add more of it to the diet.

Fiber in the Diet

A diet high in fiber is good for the body for many reasons, but reducing the incidence of breast cancer is one reason people may not be aware of. There are many mechanisms behind why fiber is associated with significantly lower breast cancer rates:

• Stable blood sugar – Cancer cells need energy to grow, and excess glucose (sugar) in the blood encourages cancer proliferation. Fiber stabilizes blood sugar.
• Lower free estrogen – Fiber can help to reduce excess estrogen, which slows the proliferation of breast cells that can become cancerous.
• Decreased appetite – Fiber helps people to feel full for longer after eating, which helps to avoid calorie overconsumption. Thus, those who incorporate fiber (especially fruits and vegetables) are less likely to face increased cancer risk from obesity.

Alcohol and the Cancer Connection

Many assume that a small drink here and there does not impact their health. Still, studies show that breast cancer risk increases by 7% to 10% for each alcoholic drink an individual consumes per day.

Researchers believe that ethanol, the alcohol found in drinks, is responsible for this increase in breast cancer risk (through its function of raising estrogen in the body); thus, it is likely that the type of alcohol does not matter as much as how often and how much an individual consumes.

Get Regular Breast Cancer Screenings

A person’s dietary choices have a role to play in their breast cancer risk, just as their genetics, family history, and other lifestyle factors do. By making minor adjustments to nutritional habits over time, an individual can boost their health in many ways and decrease their lifetime risk of breast cancer.

The professionals at Raleigh Gynecology and Wellness encourage all women to participate regularly in breast cancer screening through both mammography and self-exams at home.

Contact Raleigh Gynecology and Wellness to schedule your mammogram or learn more about how to keep your breasts healthy over the long term.

Generally, women should have a mammogram once per year starting at age 45, though the American Cancer Society recommends that women start getting mammograms at 40 if accessible. Those with higher risk factors, such as the BRCA gene, should begin screening sooner.

However, women with breast implants often believe that mammography cannot work for them. In reality, it is both possible and encouraged to get breast exams, including mammograms, whether or not you have breast implants! Getting a mammogram with breast implants is generally similar to the experience for individuals who do not have implants.

However, there are still a few things to keep in mind. Here is a guide on how mammograms are conducted on people with breast implants and any special considerations to keep in mind.

Can Mammograms Be Done With Implants?

In short—yes, mammograms can be done on patients who have had breast implants. It is best to entrust this service to a healthcare provider with experience doing breast exams and imaging for people who have implants, as the process can be slightly different than it is for individuals with only natural breast tissue. More provider experience means better pictures!

What to Expect During a Mammogram

Patients who have breast implants should plan to tell their doctor at the time they schedule the mammogram. This allows them to be paired with a technician who has the necessary experience and may require a longer appointment time since patients with implants usually need a few more pictures to be taken.

On the day of the appointment, women will prepare for the procedure as normal by avoiding lotions and creams in the torso area and then undressing in the exam room.

During the imaging process, the mammographer will use a skill called implant displacement, in which the implant is gently shifted back toward the chest wall and the breast tissue pulled forward to get the best images without the implant in the way.

Still, because of the implants, most mammographers will need to take a few additional pictures to capture as much of the breast tissue as possible. Thus, patients should expect to spend 10 to 15 extra minutes at most.

When the mammogram is complete, the patient can return to their normal daily activities. The breast implants will remain in their intended position, but patients should report any lingering discomfort to their doctor.

The Risks of Mammography With Implants

Mammography is a safe and effective method of detecting breast cancer in its earliest stages. However, there are still some minor risks for individuals with breast implants. These include:

• Rupture – While extremely rare, it is possible for the pressure exerted during a mammogram to rupture certain types of breast implants, including saline implants. The best way to reduce this risk is to work with a provider with experience providing mammography to implant patients.
• Capsular contracture – In some instances, tough, scar-like tissue forms around a breast implant after it has been placed. A mammogram can disrupt this tissue, leading to slight visual or textural changes to the breast anatomy.
• Radiation – Because women with breast implants usually need to have more imaging done to capture as much breast tissue as possible, they are exposed to slightly higher levels of radiation. However, this only amounts to a few more pictures and is still well within the safe bounds of what doctors recommend for patients.

While it is true that mammography can pose some minor risks that occur rarely, patients with implants should not be dissuaded. The advantages of mammography for identifying breast cancer early are worth the risk, and many more patients will detect breast cancer than will experience any negative side effect.

Get Your Breast Exams Done Regularly

Mammography is essential in a patient’s toolkit for preserving their long-term health and staying safe from cancer. In fact, individuals who received mammograms on the recommended schedule were 41% less likely to die due to breast cancer and saw a 25% reduction in the severity of breast cancer if diagnosed.

Having breast implants should not discourage patients from seeking out regular screening, though the process may be slightly different compared to those who do not have implants.

If you are overdue for your next breast exam or mammogram, the best time to schedule is now! The professionals at Raleigh Gynecology and Wellness understand how to complete high-quality mammography in patients with breast implants. Contact Raleigh Gynecology and Wellness today to schedule your screening!

Mammograms are an essential part of healthcare for women and individuals of any gender who are experiencing abnormalities in the breast tissue, have a family history of breast cancer, or have been born with the BRCA gene that increases the risk of breast cancer. However, getting the test results may leave patients with questions, as mammography reports are not always written in terms meant for non-medical professionals to understand.

Despite this, mammography reports all use the same layout and numerical system—so by having knowledge of BI-RADS, the Breast Imaging Reporting and Data System, patients can read their mammogram results and take a more active role in their own healthcare.

Here is what patients need to know.

What Is Included in a Mammogram Report?

Your doctor may have recommended a mammogram to check on a specific issue, or it may simply have been time for a routine mammogram to detect early changes associated with breast cancer. Regardless of the reason, the test itself will typically evaluate the same criteria:

• The composition of the breast (how much fat vs fibrous tissue))
• The position and size of any identified masses (relative to the location of the nipple)
• The location of any calcium deposits inside the breast tissue
• The level of asymmetry between the two breasts
• General features of the breast (nipple size, skin thickness)

Once this information is collected, the report will be synthesized using the BI-RADS scale. This numerical system ranks potential abnormalities and other areas of concern, providing a value that dictates what steps should be taken next.

Interpreting the BI-RADS Scale

The BI-RADS scale is a six-point system; it begins at zero and ends at six, and all results from the mammogram will be sorted into these categories. Patients can look at their BI-RADS score to understand the mammogram’s findings.

Category 0

A mammogram classed as zero on the BI-RADS scale is incomplete or part of a series. Occasionally, mammography can produce unclear results (such as if the patient moves during the exam) or the radiologist may detect a new breast mass or other changes that need further assessment.

The medical team may want to take additional images to obtain different views or to compare them to prior results. In these cases, the mammogram cannot stand alone as a diagnostic tool, so it receives a score of zero. The patient should return to the office for additional imaging.

Category 1

Patients whose mammogram results have been assigned a BI-RADS value of one have a negative test. In other words, the doctors could not find any abnormalities or areas of concern. This is good news, but continue to get mammograms regularly to identify issues while they are still minor.

Category 2

If breast tissue is categorized as BI-RADS two, the result is negative, but doctors may have described elements of the breast that were non-cancerous. For instance, if an individual has a harmless cyst in one breast, their BI-RADS result would be a two; this is normal and is no cause for concern.

Category 3

Sometimes, a doctor may find abnormal tissue, but there is only a slight chance it is cancerous. This is a typical category three case. Patients in category three should return in six months for another mammogram to see if the area has changed.

Category 4a, 4b, 4c

Patients assigned a BI-RADS four have mammogram results that are suspicious of cancer. The subcategories (a, b, and c) indicate how likely the tissue is to be cancerous (2-10%, 10-50%, and 50-95%, respectively). A breast biopsy is recommended to sample the tissue and determine next steps.

Category 5

A BI-RADS score of five indicates that the imaged tissue is at least 95% likely to be cancerous. The doctor will do a biopsy to identify the cancer cells (if present) and begin creating a treatment strategy.

Category 6

Some patients are aware that they have breast cancer and continue to receive mammograms, either to check on the efficacy of treatment or to see whether the cells are growing in new locations.

The BI-RADS category six exists to describe these patients and is only used in cases of existing breast cancer diagnoses.

Maintain Breast Health Through Regular Gynecological Care

Getting regular mammograms is one of the most important decisions patients can make when investing in good long-term health. Breast cancer is often highly treatable if it is caught in its earliest stages, and mammograms provide useful imaging to identify problematic tissue in its infancy.

The professional team at Raleigh Gynecology & Wellness is always eager to educate our patients on the importance of mammograms and how to interpret their results. Contact Raleigh Gynecology & Wellness to schedule your mammogram!

Breast cancer is one of the leading causes of female mortality, though it can affect anyone with breast tissue. One of the most essential elements of preventing breast cancer development is catching potentially cancerous growth early when it is at its most treatable. Mammography is one option for doing so, though many women also choose to do self-exams.

While both are pivotal in health care, mammography and breast self-exams serve different functions. If you have not been doing self-exams, the best time to start is now! And if you are overdue for a mammogram, take some time out of your day to schedule one today.

Do You Need a Mammogram If You Do Self-Exams?

Many people mistakenly believe that self-exams are simply a replacement for getting a mammogram. However, patients should be sure to take the time to do both.

A self-exam provides the first line of defense, allowing patients to notice potential changes to their breast tissue between doctor’s appointments.

However, mammography can visualize areas of the breast that patients cannot feel, providing a more thorough view of the breast tissue.

Thus, mammography and self-exams are not two separate strategies; they work best when used together to create the most complete picture of breast health.

What You Can Identify

Both self-exams and mammograms can help to identify potentially cancerous growth in the breast tissue, but each offers individual advantages.

With a self-exam

A breast self-exam is useful because it is simple, time-efficient, and repeatable as often as the patient desires. Many people choose to perform a quick self-exam when taking a shower or before going to sleep while lying in bed.

Self-exams allow individuals to become familiar with the typical state of their breast tissue, equipping them with the knowledge and experience to quickly identify when something has changed.

With a mammogram

A mammogram is a more intensive process that requires an office visit to visualize the breast tissue with a special machine. It can provide a picture of the entire breast, including areas that are difficult to access or too deep for manual exams to reach.

Thus, a mammogram creates a thorough image that can identify potentially cancerous growths that are too small or too remote to be felt immediately. This type of imaging can also find other problems, such as cysts that may be causing discomfort.

How to Perform a Self-Exam the Right Way

Performing a breast self-exam is simple! Starting from the nipple, gently use the pads of your fingers to push into the tissue in a straight line up toward the collarbone.

Imagine the breast as a clock and start with 12. Then, once you have completed one line, move on to 1, and then 2, and so forth until you have thoroughly examined the breast tissue in all directions.

Throughout this process, it can be helpful to repeat a line at varying pressures; start with a light touch, then do the same motion again with a heavier press. This helps to palpate surface-level and deeper tissue, allowing you to identify more potential areas of concern if they are hidden far below the skin.

Preparing for a Mammogram

Breast self-exams are a useful way to keep track of breast health at home. Still, patients should also schedule mammograms regularly—especially if they have a family history of breast cancer, a genetic predisposition, or are over the age of 40.

Getting ready for a mammogram does not require in-depth preparation; there are only a few things to keep in mind.

• Compile a list of all the medications you are taking and the results of any previous mammograms to bring with you.
• The technician will ask you to remove your top, so wear clothing that is simple and easy to take off.
• Do not wear lotion, deodorant, or any other substance applied to the skin of the torso and underarm areas, as this can appear in mammogram imaging and interfere with results.
• Try to schedule the appointment for a time when the breasts will not be tender; the two weeks after a menstrual cycle are often ideal.

Get Regular Mammograms to Preserve Your Health

Both mammograms and breast self-exams have important roles to play in a person’s overall health in the long term, and doing one does not mean that you can skip the other. If you are overdue for a mammogram, or if you have noticed something that you want to check up on, be sure to schedule as soon as possible.

Contact Raleigh Gynecology & Wellness to set up your mammogram appointment and invest in good breast health alongside your regular at-home self-exams.