Women's Health

Ovarian Cyst vs. Ovarian Cancer: Seeing the Difference With Ultrasound

3D transvaginal ultrasound with power Doppler imaging can help clinicians differentiate between an ovarian cyst vs. ovarian cancer.

The mention of any sort of ovarian pathology can make patients nervous. There has been an increase in knowledge of ovarian cancer among the public, but not as much is commonly known about ovarian cysts, either simple or complex. While there are huge differences in an ovarian cyst vs. ovarian cancer, there are also, at times, some unsettling similarities.

When patients do not understand the difference between ovarian cysts and ovarian cancer, they may become fearful or anxious. 3D ultrasound can help patients understand these issues better when looking to evaluate ovarian masses as well as provide clarity and peace of mind.

What Is an Ovarian Cyst?

Simple ovarian cysts are commonly found in premenopausal women and are usually a normal finding. While less common in postmenopausal women, according to The American Journal of Obstetrics and Gynecology, simple cysts typically do not lead to cancer or indicate an increased risk. These cysts can be managed conservatively with transvaginal ultrasound. In fact, one-third of ovaries with simple cysts will be cyst-free by the next year.

Complex ovarian cysts, which contain solid components, irregular or thick septations, internal vascularity, or debris, are another matter. However, only a very small number of complex cysts are cancerous, and they can often be differentiated through the use of 3D transvaginal ultrasound and power Doppler assessment, a CA 125 blood test and a review of patient symptoms.


Doctor disusses benign vs. malignant ovarian cyst ultrasound results with patient

What Is Ovarian Cancer?

Ovarian cancer is rare in women younger than 40. Most ovarian cancers develop after menopause, between ages of 55 and 64. According to the American Cancer Society, there is an increased risk of ovarian cancer for those with a family history of breast or ovarian cancer due to inherited mutations in the genes BRCA1 and BRCA2. Increased risk has also been found in women who are obese, have never been pregnant or breastfed or have not used oral contraceptives for more than three to six months.

It was originally thought that ovarian cancer was a silent killer with very few symptoms. However, women with ovarian cancer do report persistent and abnormal symptoms, even in the early stages of the disease. These can include bloating, pelvic or abdominal pain, difficulty eating, feeling full quickly and urinary symptoms such as increased urgency or frequency.

Differentiating Ovarian Cyst vs. Ovarian Cancer on 3D Ultrasound

In the past, clinicians have relied on signs from benign vs. malignant ovarian cyst ultrasound results to characterize masses. A simple-appearing and fluid-filled structure without solid growths and no extra blood flow likely indicate a benign cyst. More suspicious markers of a complex cyst include internal debris, thick or irregular septations within, internal areas with a solid appearance and an increased blood supply flowing to it.

3D transvaginal ultrasound is the best possible method of assessing ovaries and evaluating the characteristics of ovarian cysts. When a normal vs. abnormal ovary ultrasound is used for evaluation, tumors can be detected in earlier stages and are therefore more likely to be treated successfully.

According to a study published in Gynecologic Oncology, 3D ultrasound can produce a better ovarian pathology assessment due to its improved recognition of ovarian mass anatomy, characterization of surface features, detection of tumor infiltration, and precise size and volume measurements. 3D power Doppler imaging can also detect structural abnormalities of malignant tumor vessels, such as arteriovenous shunts, microaneurysms, tumoral lakes and dichotomous branching. This technology can enhance and facilitate the morphologic and functional evaluation of both benign and malignant ovarian masses.

Staying One Step Ahead of the Risk

While the lifetime risk of ovarian cancer for women in the general population is less than 2 percent, the risk is estimated to be 35 to 70 percent for women with BRCA1 mutation, according to the American Cancer Society. Women with a BRCA2 mutation have a 10 to 30 percent risk. An annual screening exam using 3D transvaginal ultrasound can help these patients stay a step ahead of the cancer risk.

If any sort of ovarian cyst is discovered in a postmenopausal patient, the clinician should thoroughly assess it with 3D transvaginal ultrasound until either spontaneous resolution occurs or suspicious changes are noted.

All women should listen to their bodies and make note of anything that feels unusual to them. The frequency and number of related symptoms have become key factors in the timely diagnosis of ovarian cancer. The earlier ovarian cancer is discovered, the better the chance of recovery.