Obstetrician-gynecologists (OBGYNs) are a central point of contact for women’s health, providing comprehensive care beyond reproductive and gynecological needs. They are often the primary physicians many women see regularly, guiding patients through different life stages from adolescence through menopause.
The OBGYN’s Role in Breast Health Screening
OBGYNs play a significant role in early breast cancer detection through routine health screenings. During annual visits, they perform a clinical breast exam (CBE), which involves visual inspection and manual palpation of the breasts, underarms, and collarbone. This exam checks for changes in size, shape, skin texture, lumps, or thickened areas, including subtle signs like dimpling, redness, or nipple changes.
Beyond the physical exam, OBGYNs conduct a thorough risk assessment, gathering information about a patient’s personal and family medical history. This includes inquiring about relatives with breast or ovarian cancer, and considering lifestyle and hormonal factors influencing breast cancer risk. For women at average risk, OBGYNs recommend annual mammograms starting at age 40 or 50, depending on guidelines. For high-risk individuals, earlier and more frequent screenings, potentially including breast MRI, are advised. The OBGYN’s evaluation determines the appropriate screening schedule and facilitates referrals for further imaging.
When to See Your OBGYN for Breast Concerns
Contact an OBGYN promptly if any new or unusual breast changes are noticed. While not all changes indicate cancer, a prompt evaluation is necessary. Symptoms warranting an immediate visit include a new lump or thickened area in the breast or underarm, or a change feeling different from surrounding tissue. Other concerning signs include changes in breast size, shape, appearance, or skin changes like dimpling, puckering, redness, or scaling.
Nipple changes, such as a nipple turning inward, pain in the nipple area, or any discharge other than breast milk, should be reported. Persistent breast pain not resolving after a menstrual period also warrants medical attention. While breast self-awareness helps individuals become familiar with their breasts, it is not a replacement for clinical exams or mammograms. Knowing what is normal allows for earlier recognition of changes, prompting a timely visit to the OBGYN.
Next Steps in Breast Cancer Detection
If an OBGYN identifies a suspicious finding during an exam or based on reported symptoms, further diagnostic steps are initiated. Initial follow-up includes additional imaging tests like a diagnostic mammogram or breast ultrasound. A diagnostic mammogram provides more detailed views of a specific area than a screening mammogram. Breast ultrasound uses sound waves to determine if a lump is solid or fluid-filled, differentiating between a cyst and a more concerning mass.
A breast MRI may be recommended if other imaging results are unclear or if specific risk factors exist. If imaging tests continue to show a suspicious area, a biopsy is the next step for a definitive diagnosis. Biopsies involve removing a small tissue or fluid sample from the suspicious area for microscopic examination. Common biopsy types include fine-needle aspiration or core-needle biopsy, often guided by ultrasound or stereotactic imaging. The OBGYN facilitates referrals to specialists, such as radiologists and breast surgeons, who perform and interpret these advanced diagnostic procedures.