Genevieve Woodard, MD, PhD, joins the UNC Department of Radiology as an associate professor and the new chief of the Breast Imaging Division. She sat down to talk about the advances she would like to see in the field of breast imaging and the multidisciplinary approach not only within her team but also between breast radiology and others at UNC Health.
Dr. Woodard earned her combined M.D./Ph.D. degree at the University of Pittsburgh in 2011, with her Ph.D. in epidemiology evaluating novel risk factor associations for subclinical cardiovascular disease. She completed a diagnostic radiology residency in 2016, followed by a one-year breast imaging fellowship at the University of California San Francisco.
Her current academic interests include breast imaging findings following COVID-19 vaccination, breast imaging recommendations in transgender and gender diverse patients, and educational reviews on breast infections, challenging breast procedures, and pediatric breast lesions. Recent research has included imaging guidelines in patients with prior mastectomies, pregnant and breastfeeding women, and male patients. Prior research has evaluated the association between qualitative radiogenomics and Oncotype DX recurrence score in both invasive ducal and ductal carcinoma in situ.
Dr. Woodard enjoys teaching residents and fellows in the reading room and during procedures. She was the section chair for breast ultrasound at Mayo Clinic and excels at sonographer training. She has given multiple national continuing medical education lectures on challenging breast procedures, breast imaging in transgender patients, tomosynthesis, screening breast MRI and breast MRI in the treated breast, and imaging augmented breasts.
Dr. Woodard will be settling in the local NC community with her husband of seventeen years, Joel, and their two boys Owen (age 13) and Liam (age 10).
What attracted you to the Department of Radiology at UNC?
Dr. Kohi played a significant role in my interest in coming to UNC. During our conversations, she discussed how the radiology department is evolving and our intention to become known as the best in the southeast. We talked about plans to elevate the breast imaging division. To create a department and division that will meet our academic interests, improve care for patients who come to UNC, and extend that care to patients outside of UNC with outreach programs.
What inspired you to become a doctor in the first place?
I enjoyed science from a young age and had a personal interest in medicine because my grandmother died of breast cancer. During my undergraduate studies, I worked in a basic science laboratory studying molecular pathways. This introduction to research led me to pursue a combined M.D./Ph.D. program. I chose my Ph.D. in epidemiology because I wanted to steer my attention to translational research, which ultimately was a great stepping stone for a radiology career dedicated to breast cancer. Breast radiology is a good fit with my research interests as I can assess patient risk factors associated with breast cancer and use imaging to improve patient recommendations and outcomes. As we continue to advance healthcare, we know mammography is an excellent screening exam for breast cancer. However, there are patient populations that are not getting appropriate screening that we can still make an impact on.
What advances would you like to see in your field within five years?
I would like to see we continue annual mammograms for average-risk patients starting at age 40. I would like us to readily identify patients who are at high-risk, who should be screened with mammography earlier, and who could benefit from supplemental imaging with MRI, contrast-enhanced mammography, or whole breast ultrasound. I want to improve outcomes for patient groups who have been identified as presenting with later-stage cancers, whether those are patients from under-representative groups or patients who don’t have health insurance. We want to screen as many patients as possible and identify cancer at an earlier stage for all. We know that the earlier we identify breast cancer, the better patient outcomes with less morbidity and mortality.
Can you tell me a little bit about your research?
Currently, I am working on a research project evaluating primary care providers’ knowledge and comfort with breast screening recommendations for transgender and gender-diverse patients. These results impact patient care directly as we can improve our conversations with referring providers about current guidelines and update our patient education material on our institution websites and in our waiting rooms, which can be readily available for both the providers and the patients.
Why go into academics?
I chose to pursue an academic career because of the combination of clinical work with patients, education, and research. I enjoy working with our residents and fellows, helping more junior physicians to become the next practicing radiologists in breast imaging. I enjoy the opportunity to educate trainees and sonographers in breast ultrasound, which is satisfying to see their skills improve over time. This extra effort also advances the quality of our patient care. A patient coming to UNC who has a sonographer whom a radiologist has trained is going to have superior care. Observing the benefit of these synergistic components of academics is highly rewarding.
What’s one piece of advice you’d give to somebody who’s considering becoming a radiologist?
I think radiology, specifically breast imaging, is a good fit for many young physicians because it combines clinical work, procedures, and multidisciplinary interactions. Historically, women have not chosen to go into radiology. However, breast imaging is an excellent fit for female physicians looking to maintain interactions with patients, and incorporate collegiality with physicians inside and outside of radiology, all while pursuing a work-life balance. As a breast radiologist, we are often the first physician to communicate with the patient that they may have cancer and to support them on a very challenging journey. We discuss the imaging results directly with the patient, perform their biopsies, and discuss recommendations for management with the patient and provider.
What’s one thing you wish your patients or co-workers knew about you before they met you?
I want my patients and colleagues to know I am friendly and approachable. I am a hard-working team player here to get the job done for the patients and trainees. I enjoy the team dynamics in breast imaging. We diligently work with techs, sonographers, front desk staff, and many amazing people to get patients into our imaging center, take care of them at each step of the evaluation, and get them onto the next phase of their care. We don’t come in and just read a stack of images. Our excellent team dynamics and my approachability is critical for what we do each day.
Can you talk about the multidisciplinary team approach in Breast Imaging?
We have a multidisciplinary conference with breast surgery, oncology, and radiation-oncology every Wednesday. Radiology is a significant component of this meeting. We walk through the imaging and procedures, and then the team goes from there to determine the best treatment options. Many patients come from outside institutions with partial workups or desiring a second opinion. We determine as a group if the patient needs additional imaging or biopsies, prior to treatment.
We also have an internal multidisciplinary approach to patient care. The first step is having the patient come in for a screening mammogram. If we identify an abnormality, they are brought back for diagnostic imaging and often seen by a different radiologist. This means there is a second set of eyes looking at the imaging to determine if a biopsy is warranted. A third radiologist may perform the biopsy; then the biopsy results are discussed as a group, ensuring everyone agrees on the diagnosis and recommendation. Our internal checks-and-balance trickles down to our residents and fellows, so they learn the whole process even though they may have only been directly involved in one component of the patient’s care. This model is also great for patients because there will always be 2 to 3 different radiologists looking at their imaging.
What would it be if you could give your younger self one piece of advice?
Don’t give up. It’s a long road, a marathon, and it has its challenges, but you will have a ton of support along the way. Notably, strong female mentors have been important throughout my education and early career and will continue to be tremendous role models and support in the future. So yes, it’s hard, but you’ll get through it.
What profession did you want to be when you were a little kid?
A marine biologist or an archaeologist. It was always within the realm of science, but then it went from animals to humans. I think the shift happened for practical reasons, looking down the road to the career that best suited me. But I also believe the role models I had significantly impacted my future career.
If you could pick the brain of someone alive or dead, who would it be and why?
I’ve had so many female mentors from whom I’ve gotten incredible advice over the years, my undergraduate research advisor, Ph.D. advisor, and prior residency and fellowship faculty. The most immediate person I would like to pick their brain and learn from to better myself as an academic leader would be Dr. Kohi. She has progressed so far throughout her career and does not seem to fear challenges and next steps. She has an impressive academic record and has always been a great advocate for female radiologists. I look forward to learning from her as I continue my academic career.
What do you do when you aren’t working?
I enjoy exercising. I’m a big Peloton fan. My husband and I set up a great workout room, which we enjoy using together. We enjoy cooking. During the pandemic, we got a sourdough starter from a lady in San Francisco, that we have had going on for two and a half years. We successfully transported it from Minnesota to our new home in North Carolina so that we can keep the traditional weekly pizza night. Gardening was a big thing for me back in Minnesota. Although I’ve heard there are some huge scary snakes and spiders here. So, I’m not sure how much gardening I will be doing. We have two boys and four cats to keep us very busy.
How would you describe yourself in one word?
If you could have one superpower, what would it be and why?
I want the superpower to foresee people’s reactions or emotional responses to a situation or discussion. Having this would help prepare for everyday interaction so the best outcome could occur. This applies to work and home, your kids, and even people you meet on the street. We always try to be nice, friendly, approachable, kind, and caring to people, but sometimes, you are stuck in difficult situations that can be very challenging. A little foresight would be really helpful in navigating life!