Breast Care & Referrals — Coordinated Breast Health Management at LWH
Breast health is a core component of gynecologic care — and one of the areas where having a consistent, knowledgeable physician managing your longitudinal care makes the most difference. Dr. Andrei provides clinical breast examination, mammography coordination, high-risk screening protocol management, and referral to breast surgery, breast oncology, or clinical genetics when a finding or risk profile warrants subspecialty evaluation.
Lapeer Women’s Health does not perform mammography or breast biopsy. What Dr. Andrei provides is the clinical framework around those procedures — ordering and interpreting results in the context of your personal and family history, determining whether a finding requires expedited evaluation or routine follow-up, and ensuring that nothing falls through the gaps between your gynecologist and your radiologist.
For patients with an elevated lifetime risk of breast cancer — based on family history, genetic testing, or dense breast tissue — Dr. Andrei coordinates enhanced screening protocols, discusses chemoprevention when indicated, and provides ongoing risk counseling as part of the ongoing care relationship.
Breast Health Services — What Dr. Andrei Manages
These are the breast health components Dr. Andrei addresses as part of ongoing gynecologic care at Lapeer Women’s Health.
Clinical breast examination
Systematic palpation of the breast tissue, nipple, and axillary lymph nodes performed at the well-woman exam and at any visit where a breast concern is reported. Clinical findings are documented and followed with appropriate imaging or referral. Dr. Andrei teaches breast self-awareness technique and discusses the role of self-examination at every relevant visit.
Mammography coordination
Screening mammography orders placed at annual well-woman visits per ACOG guidelines — annually starting at age 40 for average-risk patients. Dr. Andrei reviews mammography results with you, discusses what BIRADS categories mean, and determines the appropriate next step for each finding. Results are not simply forwarded to a portal without clinical context.
Dense breast tissue management
Women with heterogeneously dense or extremely dense breast tissue have reduced mammographic sensitivity and elevated breast cancer risk. Dr. Andrei discusses supplemental screening — breast ultrasound or MRI — for patients with dense breasts, particularly those with additional risk factors, and coordinates supplemental imaging orders.
High-risk screening protocol management
Women with a lifetime breast cancer risk of 20% or greater — based on family history, BRCA status, prior atypical biopsy, or radiation exposure — qualify for annual breast MRI in addition to mammography. Dr. Andrei calculates lifetime risk using validated models and coordinates enhanced screening protocols for qualifying patients.
Genetic testing coordination
Patients with significant family history of breast or ovarian cancer — particularly first-degree relatives with premenopausal or bilateral disease — may benefit from BRCA1/2 testing or expanded hereditary cancer panel testing. Dr. Andrei identifies candidates, discusses the implications of testing, and provides referral to genetic counseling when indicated.
Referral to breast surgery and oncology
When a clinical finding or imaging result requires biopsy or surgical evaluation, Dr. Andrei provides a direct referral to a breast surgeon at McLaren Lapeer, McLaren Flint, or Henry Ford Rochester. She remains involved in the care coordination between the gynecologic and surgical components of your care.
Mammography Timing — What Dr. Andrei Recommends and Why
Breast cancer screening recommendations vary by organization — and the differences matter clinically. Dr. Andrei applies ACOG guidelines while discussing the individual risk factors that may justify earlier or more frequent screening for specific patients.
- Average-risk women: annual mammography beginning at age 40 — ACOG recommendation
- Women with first-degree relative with premenopausal breast cancer: begin screening 10 years before the relative’s age at diagnosis
- BRCA1/2 carriers: annual mammography plus annual breast MRI beginning at age 25–30
- Prior chest radiation (e.g., Hodgkin’s lymphoma treatment): annual mammography plus MRI beginning 8–10 years after radiation or at age 25, whichever is later
- Dense breast tissue with additional risk factors: supplemental ultrasound or MRI discussed and coordinated
- No upper age limit for screening in women with a life expectancy of 10 or more years
“Breast health management is not just ordering a mammogram every year and moving on. It is understanding each patient’s risk profile, making sure the right screening is happening at the right frequency, knowing when a result needs immediate action versus watchful waiting, and being the physician who actually explains what the result means.”
- Mammography orders placed at your annual visit — not left to self-referral
- BIRADS results reviewed with you directly — Dr. Andrei explains what each category means
- Expedited referral for BIRADS 4 and 5 findings — no delays waiting for a routine follow-up slot
- Genetic counseling referral for patients meeting testing criteria
- Chemoprevention discussion (tamoxifen, raloxifene) for high-risk patients who qualify
- Coordination with breast surgeons at McLaren and Henry Ford system hospitals
Questions About Breast Care at LWH
Breast Health That’s
Actually Managed.
Clinical breast exam, mammography coordination, high-risk screening management, and referral when needed — breast health as a continuous part of your gynecologic care, not an annual checkbox.
The information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
Gynecologic care for women of every age
Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.