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Ultrasound uses special sound wave equipment to examine internal structures such as the ovaries. Transvaginal ultrasound uses a small probe inserted into the vagina to look for abnormalities of the ovaries, tubes and uterus.
One large study reviewed transvaginal ultrasound as a screening for ovarian cancer in women over age 50 or high-risk women over age 30. In this study 90 women underwent exploratory laparotomy (exploratory surgery of the abdominal organs) based on findings on the ultrasound. Of those 90 women, six had ovarian cancer: five were found at stage 1, the most treatable stage. In this study, none of the women with ovarian cancer had an elevated CA 125 test, a blood test sometimes elevated with ovarian cancer. A larger and more recent study examined ultrasound screening for early detection of ovarian cancer in high-risk women. In this study most ovarian cancers found were diagnosed at stage III, a more advanced stage. Further, all these women had normal scans in the previous year. The authors of the second study concluded that ultrasound was of limited value for finding ovarian cancer at an early stage. A study which reviewed published research on ovarian cancer detected through screening concluded that high grade serous ovarian cancer (the type of cancer that usually develops in mutation carriers) is more likely to be diagnosed at advanced rather than early stage, even if found during screening. Although transvaginal ultrasound doesn’t have a high sensitivity or specificity, some health care providers will use ultrasound combined with CA-125 for screening those women who are not prepared to undergo risk-reducing surgery to remove their ovaries and fallopian tubes.