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The Role of Ultrasound and MRI in Breast Cancer Screening

Routine Gynecologic Care

Raleigh Gynecology May 5, 2025

supporting breast cancer awareness conceptEarly detection of breast cancer can make a huge difference in treatment outcome. Mammograms remain the gold standard in breast cancer screening, but they don’t always tell the whole story, especially for women with dense breast tissue or higher risk factors.

Ultrasounds and magnetic resonance imaging (MRI) can offer a clearer picture when traditional imaging falls short. These advanced imaging tools can reliably identify cancers that might otherwise go undetected, giving patients and doctors the best chance at early intervention.

This blog takes a closer look at how ultrasounds and MRIs can complement mammograms, providing a more thorough and effective strategy for breast cancer detection, especially for women at high risk.

Breast Ultrasound and MRI for Cancer Screening

Breast ultrasound and MRI offer enhanced imaging capabilities, providing more detailed views of breast tissue that can improve diagnostic accuracy, detect abnormalities that may have been previously missed, and reduce unnecessary biopsies.

By providing complementary views beyond standard mammography, these modalities improve early detection and serve as valuable tools in an exhaustive screening strategy.

Ultrasound Technology

Breast ultrasounds use high-frequency sound waves to gain a more detailed view of the breast’s structure. This technology is commonly used as a supplemental screening tool for women who are at a higher risk of breast cancer.

For instance, your provider may recommend an ultrasound if a mammogram suggests a change in the breast tissue, or a potential abnormality is discovered during a breast exam. Ultrasounds may also be recommended for women with dense breasts and those who are under 30 years old or pregnant.

What makes breast ultrasounds particularly useful is their ability to distinguish between fluid-filled cysts and solid masses. However, ultrasound technology does have its limitations. It is not adept at identifying microcalcifications, or tiny calcium deposits, which can be an early sign of breast cancer.

MRI

A breast MRI is a highly sensitive imaging test that generates 3D images of the breast using powerful magnets and radio waves. Unlike mammograms, this technology does not use radiation, making it a potentially safe option for monitoring high-risk patients who require frequent scans. The American Cancer Society recommends that women with a high risk of breast cancer get an MRI annually, often starting at age 30.

closeup of skilled female doctor in glasses carrying out ultrasound examination breast of unrecognizable young woman patient in medical clinicBreast MRIs can be especially useful for finding small or hidden tumors that might be overlooked on a mammogram, especially those in dense breast tissue. They can also be used to evaluate the extent of cancer in patients who have already been diagnosed.

However, breast MRIs are extremely sensitive and can sometimes produce false positives, meaning they may detect abnormalities that are not cancerous. There is also emerging data that suggests repetitive use of contrast dye for MRIs may lead to harmful effects in some patients.

Effectiveness of Ultrasounds and MRIs

While women’s health technologies have come a long way over the last decade, no tool is infallible. The overall effectiveness of ultrasounds and MRIs can differ based on a variety of factors. When used in conjunction with a mammogram, supplemental imaging techniques, such as ultrasounds and MRIs, can provide additional layers of detection that improve accuracy and facilitate early diagnosis.

Ultrasound Effectiveness

Regular breast cancer screening helps identify cancer earlier, helping to significantly reduce breast cancer deaths. Some studies suggest that early screening can reduce deaths up to 40%. Ultrasound can serve as a valuable tool for breast cancer detection, especially when used as a supplemental tool to evaluate suspicious areas found on mammograms or in dense breast tissue.

A systematic review found ultrasounds detect breast cancer with a sensitivity of around 80%. They are also particularly useful for guiding biopsies by pinpointing abnormal areas with high precision, as well as evaluating palpable lumps that don’t show up clearly on mammograms.

MRI Effectiveness

Breast MRIs are considered one of the most sensitive imaging methods, capable of detecting smaller and more aggressive cancers that may not be visible on mammograms or ultrasounds. They can be especially effective for women at high risk of breast cancer, such as those with BRCA1 or BRCA2 gene mutations. A breast MRI may also be recommended for women with a history of breast cancer to detect recurrences.

While MRIs are highly sensitive for detecting breast cancer, they should not be used as a sole screening tool. This technology can miss certain cancers that a mammogram would find and is also more likely to result in false positives that can lead to costly additional testing and unnecessary biopsies.

Improving Outcomes with Ultrasound and MRI

Combining ultrasounds and/or MRIs with mammograms offers a more thorough evaluation of breast tissue, increasing the likelihood of detecting abnormalities early. This is especially valuable for women at high risk, as these tools provide enhanced sensitivity and deeper insights for a more detailed and proactive approach to breast cancer screening.

Schedule Your Next Breast Cancer Screening

malignant tumor that forms in breast cells, often detectable by lumps, changes in shape, or other noticeable abnormalitiesCaring for your breast health is necessary for overall wellness, and early detection offers you the best chance for effective treatment and a positive outcome. Mammograms, ultrasounds, and MRIs each play an important role in keeping you informed and empowered. Take time to discuss your risk factors with your healthcare provider to determine the best diagnostic equipment for you.

If you’re due for a screening or have concerns about your breast health, contact Raleigh Gynecology & Wellness. We have an all-women team that focuses on patient comfort and privacy, and we understand the personal nature of gynecological care.

Our long-standing gynecological expertise and compassionate, patient-centered approach make us a trusted partner in your breast health journey for all stages of life. Early detection can save lives, and we’re here to provide the care and support you deserve.

Raleigh Gynecology April 28, 2025

women holding condom and birth control pills in both handsBirth control is one of the most common medical interventions that women around the world receive. Depending on the geographic area, as many as 18% of all women are currently taking oral contraception, with another 10% relying on IUDs and implants.

About 24% choose sterilization as their pregnancy prevention method of choice. Contraceptive care accounts for a significant portion of women’s healthcare from their OB-GYN. Still, most women do not settle on just one method for their entire lives.

It is common to switch among forms of birth control depending on the desired effects, potential side effects, and long-term need. Making the switch can present its share of challenges, and women should understand ahead of time how their bodies may respond and what to expect.

Here is some guidance for managing the adjustment period after switching birth control and some methods for making the transition as seamless as possible.

How to Make the Switch

There are multiple ways to switch to a new type of birth control. The right one for any woman will depend on the current method and what the patient wants to switch to, the evaluation of any existing medical conditions, and whether she is at risk of becoming pregnant during the switch.

In most cases, a woman may be able to stop using their previous birth control and begin using a new one right away. In other cases a woman may do better with an overlapping transition. In this scenario, she may be using two contraceptives at once. An example would be starting a birth control pill with an IUD still in place with a plan to remove the IUD once she is well established on the birth control pill.

The overlap method may help the body achieve a smoother transition in women for whom hormonal fluctuations cause significant side effects; however, , it is not always possible to transition in this way..

As-Needed

Some women elect to stop birth control for longer periods of time, such as when they do not actively have a partner. During this window, they may choose to switch their birth control method to condoms or another alternative. Some women benefit from this more drawn-out switching method, as it allows the body to fully return to its no-contraceptive homeostasis before trying a new product later. However, pregnancy risk is higher during this time if, for example, a condom breaks.

Adjusting After a Birth Control Switch

Regardless of which type of birth control switching process a woman chooses, she may experience some minor side effects. These can include:

  • women taking birth control pillMood changes
  • Libido changes
  • Changes to the menstrual cycle
  • Spotting
  • Tender breasts
  • Headaches
  • Nausea

While some adjustment period is normal, women should pay attention to their side effects. For most women, side effects from changing birth control methods can last a few months. It can be helpful to keep a journal detailing how the patient feels emotionally and physically at the end of each day, which helps to track side effects as they change over time.

In general, women should expect that the side effects gradually decrease in severity as they adjust to their new contraception. If side effects worsen or do not resolve within a few months, a gynecologist can help the patient understand their options.

For many women, their bodies respond best to certain brands or types of contraception. There is usually no need to remain beholden to a specific brand; instead, women should listen to their bodies and work with their GYN team to find a solution that fits them.

Talk to Your Gynecologist About Switching Birth Control

birth control pills and injectionChoosing (and using) birth control is one of the biggest decisions a woman may make in her lifetime. However, in the quest to find the right fit, many women will need to switch between birth control methods. The women at Raleigh Gynecology & Wellness want to make this switch as easy as possible so you can flourish!

We have been there and understand the relief of finding an option that works well with your body. Contact Raleigh Gynecology & Wellness today to schedule your contraceptive appointment, discuss switching, and learn more about how to manage this switch comfortably.

Raleigh Gynecology April 21, 2025

aged women checking mammogram result with a doctorMany factors, such as dietary habits and exposure to harmful substances, impact the risk of breast cancer. However, one of the most impactful drivers behind the development of breast cancer is a family history. If other people in a woman’s family have experienced breast cancer, those related to them may have an increased risk as well.

Women at increased risk for breast cancer based on family history may require modified breast cancer screening, including earlier mammography, more frequent breast exams or even additional forms of breast imaging such as breast MRI or ultrasound.

Each woman needs to understand her family history to make wise decisions about her breast healthcare. Those who no longer have access to their family history, such as in the case of closed adoptions, still have options to uncover whether they, too, face a higher risk.

The Genetic Component of Breast Cancer

The reason that some people face a higher chance of developing breast cancer than others comes down to heredity. Because a person’s genes are influenced by their parents, some problematic genes can continue to move through generations. In fact, between 5% and 10% of breast cancer cases are in those with an increased risk through family history. Multiple genetic factors may increase breast cancer rates. Several genes have been identified related to breast cancer risk.

About 70% of what contributes to breast cancer development via heredity is still not clear; what doctors do know is that when people’s family history predisposes them to breast cancer, they may also face an increased risk breast cancer that develops on both sides, a younger than average age of cancer onset, and an increased risk of other types of cancer such as ovarian cancer.

Who Is at Risk?

Knowing whether a woman is facing an increased risk of cancer due to genetics can be challenging. The main people who must contend with higher risk are:

  • Those with a known genetic mutation (such as BRCA1 and BRCA2, or “breast cancer gene 1/2″)
  • Anyone of Jewish ancestry
  • Those whose family has had previous cancer development at young ages
  • Those whose parent or sibling had breast cancer before age 40 (or, if male, developed breast cancer at all)
  • Those whose parent or sibling developed cancer in both breasts, regardless of age
  • Those whose family has had at least three cases of breast cancer among parents, siblings, aunts, uncles, and grandparents

How to Be Assessed for Genetic Risk

mammography testing with Raleigh OBGYNGenetic counseling is available for those who have been deemed high-risk due to their family history. Doctors still cannot test for every factor that contributes to an increased risk of cancer, but several genes have been identified that can contribute to breast cancer risk.

In addition to BRCA1 and BRCA2, the most common genetic variants associated with increased risk, other things the genetic test may uncover relate to genes such as:

  • TP53
  • CDH1
  • PTEN
  • STK11
  • RAD51C
  • RAD51D
  • ATM
  • CHEK2
  • BRIP1
  • PALB2

Patients do not need to know what these genes mean or stand for! Instead, they should understand that many genes can contribute to breast cancer risk, often because the genes are “turned off.” Where most people’s genes work to suppress tumors or accurately copy DNA, people who have the above-mentioned genetic variants may not have tumor suppression genes that are properly activated, or their DNA may be more likely to be copied incorrectly.

How Family History Impacts Mammograms

A person’s family history should indicate how often they schedule their mammograms. Women with no family history should receive a mammogram at least once every other year, ideally once a year, starting at age 40. Those with the BRCA genes or other variations still receive a mammogram only yearly.

However, they may also be encouraged to get a breast MRI annually to provide further visualization of the breast tissue. These screenings also typically start earlier for those with a family history, potentially as young as 25, depending on the details.

Get Your Mammograms Often

female doctor in a modern clinic explains the mammography procedure to a topless adult patient undergoing a mammogramMammograms are an invaluable tool for diagnosing breast cancer, both in those with no family history and those whose families have faced this health challenge before. Knowing your breast cancer risk from genetics is essential for making smart decisions about your healthcare and when to receive screening.

The friendly team at Raleigh Gynecology & Wellness is always happy to welcome our patients who have questions about the genetic components of their health. Our women-only team understands that uncertainty around cancer risk can cause much anxiety, and we are happy to help you stay healthy and informed! Contact Raleigh Gynecology & Wellness today to schedule an appointment.

Raleigh Gynecology April 14, 2025

girl holding birth control pillsWhen the time isn’t right to start or grow your family, birth control offers a reliable and convenient way to manage your contraceptive care. Although several choices are available, two of the most common progestin-only methods are the birth control shot (Depo-Provera) and the birth control implant (Nexplanon).

Both provide long-lasting pregnancy prevention but work in different ways. Find out the differences between the shot and implant to make an informed decision about your contraceptive care.

The Shot

The birth control shot is an injectable contraceptive that offers long-term pregnancy prevention. As a progestin-only method, it does not contain estrogen, making it a suitable option for individuals who cannot use combination hormonal contraceptives.

How It Works

Women who value convenience often favor the shot as it’s only administered once every three months. It works primarily by blocking ovulation, thickening the cervical mucus to stop sperm, and thinning the uterine lining to prevent implantation. For maximum effectiveness, it must be received on a schedule.

Pros:

  • Highly Effective – When used correctly, the shot is over 99% effective.
  • Low Maintenance – Only requires an injection every three months, reducing the need for daily or frequent reminders.
  • Discreet – There are no visible signs of birth control, and it does not require insertion or a device.
  • May Reduce Menstrual Symptoms – Many users experience lighter periods or stop having periods altogether over time.
  • Estrogen-Free – A good option for women who cannot take estrogen-based contraceptives.

Cons:

  • Requires Regular Injections – Missing a shot can reduce effectiveness, requiring strict adherence to a schedule.
  • Potential Side Effects – May cause weight gain, mood changes, headaches, and irregular bleeding.
  • Bone Density Loss – Long-term use has been linked to decreased bone mineral density, which may be a concern for some users.

Depo-Provera

Depo-Provera is the brand name for a birth control shot that contains depot medroxyprogesterone acetate (DMPA) as its active ingredient. It is typically injected into the muscle of the upper arm or buttocks. As it lasts for three months, it provides a convenient alternative for those who prefer not to take daily birth control pills but are not ready for longer-term options, such as an implant or IUD.

The Implant

woman holding a birth control implantThe birth control implant is a long-acting, reversible contraceptive that provides years of highly effective pregnancy prevention. It’s a tiny, flexible rod measuring approximately 1.6 inches and is inserted just under the skin of the upper arm.

How It Works

Implants work by releasing steady, low doses of progestin into the bloodstream to block ovulation, thicken cervical mucus to stop sperm, and thin the uterine lining to prevent implantation. Once inserted, it remains effective for up to 3 years.

Pros:

  • Extremely Effective – Over 99% effective at preventing pregnancy, with a failure rate lower than most other contraceptive methods.
  • Long-Lasting – Protects against pregnancy for three years without requiring maintenance.
  • Low-Hormone Option – Releases a consistent, low dose of progesterone, avoiding hormonal fluctuations.
  • Reversible – Can be removed at any time, and fertility typically returns quickly after removal.
  • Estrogen-Free – Suitable for individuals who cannot use estrogen-containing birth control.

Cons:

  • Requires a Minor Procedure – Must be inserted and removed by a healthcare provider, which may cause slight discomfort.
  • Potential Side Effects – Some users experience irregular bleeding, headaches, mood changes, or weight gain.
  • Not Suitable for Everyone – May not be recommended for individuals with certain medical conditions, such as those with a history of blood clots.

Nexplanon

Nexplanon is the most commonly used brand of birth control implant. The tiny plastic rod is placed under the skin of the upper non-dominant arm in a fast outpatient procedure. Nexplanon is radiopaque, meaning it can be detected by X-ray if necessary. Once inserted, it continuously releases progestin to provide long-term pregnancy prevention, making it a highly convenient and effective contraceptive option.

Which Option Is Best for You?

Choosing between the birth control shot and implant depends on your lifestyle, health needs, and personal preferences. If you prefer a low-maintenance, long-term option that lasts for years, the implant may be the best choice.

However, if you like the flexibility of an injectable method that isn’t permanent, the shot may be a better fit. Consider factors such as side effects, scheduling requirements, and future pregnancy plans. Always consult with a healthcare provider to determine the best contraceptive care for you.

Trust Raleigh Gynecology & Wellness for Your Contraceptive Care

contraception pills on blue backgroundBoth the birth control shot and the implant offer highly effective, long-term contraception, but the right choice depends on your individual needs and lifestyle. While the shot provides flexibility with regular injections, the implant offers years of hassle-free protection. By knowing the pros and cons of each method you can make an informed decision about your contraceptive care.

If you’re unsure which option is best for you, contact Raleigh Gynecology & Wellness today to speak with a healthcare professional about your birth control options. We offer specialized and compassionate care for women of all ages to ensure that you receive services that best suit your needs.

Raleigh Gynecology March 3, 2025

NC female primary care doctor with patient conducting mammography examinationMammograms can tell a woman much about her breast health, but they are an easy thing to avoid. In fact, about two-thirds of women expect mammograms to be painful, which plays a significant role in whether they choose to schedule them on time every year (or at all).

While it is true that mammography will not be as pleasant as enjoying a home-cooked meal, it does not have to be severely uncomfortable! There are many things a woman can do before and during her mammogram to make the process more comfortable.

From scheduling strategically to working with a trusted team, any patient can take charge of their mammography and see better (and more comfortable) results.

Schedule Before Problems Worsen

One way to improve the comfort of a mammogram is to schedule it as soon as a problem becomes noticeable (or even before any issues seem to exist). Waiting until the breast tissue itself becomes uncomfortable not only exposes a patient to a higher risk of breast cancer but also contributes to discomfort during testing.

A woman who is experiencing swollen nipples or who feels a large lump may feel more discomfort when these tissues are put under pressure with mammogram testing. This is why regular mammograms are important, as they can spot issues before reaching this point.

Wait Until After Your Period

Breast tissue changes throughout a woman’s menstrual cycle as hormones fluctuate. Immediately prior to and during a woman’s period, the breasts can be especially tender. It is smart to schedule a mammogram for the week after menstruation, when the breasts have recovered and are no longer as sensitive to touch or pressure.

Choose Water

While many women begin their days with coffee, this could be a less-than-ideal choice for mammogram day. Soon after consumption, caffeine functions as a vasoconstrictor, narrowing the blood vessels.

This narrowing (and the increased blood pressure that comes with it) is why some people experience headaches after drinking caffeine. However, it can also be a driver of discomfort during a mammogram.

Because the breasts experience higher blood pressure than normal, the force exerted by the mammography machine can increase this pressure to even greater levels, causing discomfort. To avoid this, be sure to drink water for a few days before the mammogram.

Try OTC Medications

breast cancer diagnosis from mammography results

It is safe to take over-the-counter pain relievers, such as ibuprofen, before a mammogram. Studies show that women who took acetaminophen (Tylenol) one hour before their screening reported less discomfort than those who did not. Just be sure that taking this medication will not interfere with other medicines!

Stay Still

A mammogram exerts pressure on the breast tissue in specific ways to gain a clear picture. Remaining as still as possible helps to make sure the machine is putting pressure in the right places instead of pressing on a sensitive area.

If a patient needs help standing still, such as if they regularly use a walker, a good mammography team will always be happy to assist.

Communicate

Many women assume they should be quiet during their screenings so the technicians can work. However, women are encouraged to communicate with their team! If they are feeling discomfort, patients should let their practitioner know so they can adjust the positioning.

Get to Know Your Team

It can be very stressful to be poked and prodded by strangers, and this sense of unfamiliarity can lead to an increased sense of pain. From being tense to anticipating pain where none exists, patients face real consequences when they do not know the team they are working with!

Take time before a mammogram to get to know the people operating the machine or taking notes. By trusting those in the office, women can approach mammography with less tension and discomfort.

Do Not Fear a Mammogram

young woman is having mammography examination at the hospital or private clinic with Raleigh, NC female doctorA mammogram does not have to be a cause for concern! Whether you have experienced an uncomfortable mammogram in the past or are nervous about your first time, it is important to choose a team that understands what you are going through.

Raleigh Gynecology & Wellness’ all-woman team has been right where you are, and we know just how intimidating a mammogram can be with the wrong people. That is why we are eager to help our patients have a positive experience so they can approach their breast health with confidence. Contact Raleigh Gynecology & Wellness today to schedule your appointment!

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