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Early-detection demo · Ovarian cancer

O-RADS US 4 adnexal mass · BRCA1 surveillance catch

Right adnexal complex cystic-solid mass · 4.3 cm · solid component with arterial flow — O-RADS US 4 (intermediate-high risk).

Patient: Helena · 52 · BRCA1 carrier · post-menopausalModality: TVUSRisk: high · 81/100
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01

Risk profile

What OCTON knew before the scan
Risk
81
high
Tier
high
BRCA1 c.68_69delAG · maternal aunt ovarian cancer 58 · declined risk-reducing salpingo-oophorectomy at 40 · CA-125 climbing 18 → 64 over 6 months.
Contributing factors
  • BRCA1 pathogenic variant+38
  • Family history (first-degree)+18
  • Post-menopausal+12
  • Rising CA-125 (18→64)+12
  • No prior pregnancy+5
Narrative

Helena's BRCA1 status was identified at 40 but she deferred RRSO. Twice-yearly TVUS + CA-125 trended upward over 6 months — early-detection pathway working as designed.

02

Scan + AI report

What TVUS found · Transvaginal ultrasound with color Doppler
TVUS · DEMO
O-RADS US 4
OCTON · scanning · live
conf 0.85
OCTON Impression · 85% confidence

Right adnexal complex cystic-solid mass 4.3 × 3.6 cm with mural nodule and arterial-pattern Doppler flow. No ascites. Contralateral ovary normal.

Findings
  • Complex cystic-solid mass · 4.3 cm with mural nodule · Right adnexa43 mm
  • Arterial-pattern internal vascularity (CS 4) · Mural nodule
  • No ascites; uterus / left ovary normal · Pelvis
Differential diagnosis
  • High-grade serous ovarian carcinoma (early)55%
  • Borderline serous tumor18%
  • Endometrioma with mural change15%
  • Sex-cord stromal tumor12%
Recommended actions
  • ▸Pelvic MRI with O-RADS-MRI scoring within 2 weeks
  • ▸Gynecologic-oncology referral; surgical staging if MRI confirms suspicion
  • ▸ROMA score (CA-125 + HE4) and CEA / CA 19-9 panel
Caveats
  • BRCA-driven tumors typically high-grade serous — favor STAT specialty referral.
  • RRSO discussion remains relevant post-resection for contralateral risk reduction.
03

360° Preventative plan

Drugs · surveillance · diet · exercise · lifestyle — generated for this case
Clinical anchors
Drugs · labs · imaging · surveillance
Medical
Transvaginal US + CA-125 + HE4
FrequencyEvery 6 months
Startsage 30
NCCN Genetic/Familial Ovarian v1.2025
Medical
Risk-reducing salpingo-oophorectomy
FrequencyOnce (35–40 BRCA1)
Startsage 35
NCCN Genetic/Familial Ovarian v1.2025
Monitoring
Pelvic MRI on O-RADS US ≥ 4
FrequencyAs indicated
Startsage 30
ESGO 2023
04

What changed

The early-detection win

Twice-yearly BRCA1 surveillance caught a 4.3 cm adnexal mass at O-RADS US 4 — early surgical staging maximizes cure-rate.

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