Learn more about breast MRI, contrast enhanced mammogram (CEM), breast ultrasound, and genetic counseling.
At Elizabeth Wende Breast Care (EWBC), we combine risk assessment with advanced imaging options for patients who may benefit from supplemental screening. Understanding your breast cancer risk can help guide additional imaging tests and the most optimal time interval.
ADVANCED BREAST SCREENING: What are the key benefits for patients?
Personalized screening means your plan is based on your individual risk factors and breast density and may include recommendations for when to start screening, and which tests (such as mammography, ultrasound, and/or MRI) are most appropriate.
Our team helps you understand your personal breast cancer risk and develop a screening plan that fits your needs. You will receive guidance on whether genetic counseling and/or genetic testing may be appropriate for you and your family.
What is CANCER RISK ASSESSMENT?
By completing a health history questionnaire, EWBC uses validated tools to estimate your lifetime risk of breast cancer based on factors such as your personal and family history, breast density, prior biopsies, age, and other relevant information. Knowing your risk helps you and your health care provider choose an up‑to‑date management plan and determine whether genetic counseling/testing and advanced screening may be appropriate.
Your results help guide screening recommendations. Being labeled “high risk” does not mean you will develop breast cancer.
ADVANCED SCREENING
BREAST MRI
Breast MRI is a highly sensitive imaging exam that uses a magnetic field and radio waves (no radiation). It may be recommended in addition to mammography for patients at higher risk for breast cancer.
Who may benefit from Breast MRI?
- Known hereditary cancer gene mutation (or a first-degree relative with one)
- Lifetime breast cancer risk of 20% or higher based mainly on family history
- Prior chest radiation at a young age
- Dense breast tissue
Most appointments take about an hour, with scan time typically 15–20 minutes. A member of our team will contact you before your exam to review safety screening and preparation.
BREAST ULTRASOUND
Breast ultrasound may be used with mammography—and sometimes MRI—to evaluate a specific finding or to provide additional information in patients with dense breast tissue. Ultrasound complements other breast imaging, but it does not replace mammography or breast MRI. When a concern is seen on a mammogram or MRI, or noted on a breast exam, ultrasound is often performed as a diagnostic test to further assess the area and help determine whether a mass is fluid‑filled (a cyst) or solid.
While it is not a stand‑alone screening test, ultrasound can add important detail that helps your care team make the next best recommendation.
CONTRAST-ENHANCED MAMMOGRAM (CEM)
A contrast enhanced mammogram (CEM) is a specialized mammogram performed after a small amount of iodine-based contrast is injected into a vein. Contrast can help highlight areas with increased blood flow, which may make some cancers easier to see—especially in patients with dense breast tissue or when additional evaluation is needed.
CEM may be recommended for some patients who need problem-solving after other imaging or who are candidates for advanced screening when breast MRI is not appropriate or not available. Because it uses contrast, your care team will review kidney function, contrast allergy history, and other factors to determine whether CEM is right for you.
GENETIC COUNSELING
Although EWBC proactively screens patients for hereditary breast cancer risk, genetic counseling is available for patients at risk for any hereditary cancer syndrome. Genetic counseling includes review of personal and family history, determination of eligibility for genetic testing, and discussion of risks, benefits, and insurance coverage.
Appointments are offered in person and by teleconference. Call our genetic counseling staff at (585) 758-7041 to schedule your appointment. Please have your insurance information available and be prepared to discuss details regarding your personal and family history of cancer (including specific diagnoses and ages of onset).
Please note: If you previously tested negative for BRCA1 or BRCA2, you may still be a candidate for additional genetic testing. Current testing protocols may include panels with dozens of cancer-related genes.
Genetic Counseling FAQs
Who should consider genetic counseling?
Genetic counseling may be helpful if you have:
- Breast cancer at a young age (for example, 45 or younger)
- Ovarian cancer or male breast cancer in you or your family
- Several relatives on the same side of the family with related cancers (breast, ovarian, prostate, colon, pancreatic)
- Ashkenazi Jewish heritage
- A relative with a known hereditary cancer gene mutation
Why consider genetic counseling and testing?
Genetic counseling and testing can clarify inherited risk and help you and your health care providers choose a personalized plan. Depending on results, recommendations may include:
- More intensive screening (which may include breast MRI)
- Risk-reducing options (surgery and/or medication) when appropriate
- These interventions can support early detection and/or prevention of cancer.
- What happens during a genetic counseling appointment?
Appointments typically take 30–60 minutes. We review your personal and family history, discuss whether testing may be helpful, and go over the risks, benefits, and limitations so you can decide what’s right for you.
If you choose testing, a blood draw may be collected. Results are typically available in about three weeks.
Does insurance pay for genetic testing?
Many insurance plans cover testing when criteria are met. Our staff can help review requirements and obtain prior authorization if needed.
NEXT STEPS
If you have questions about your personal or family history of cancer, cancer risk assessment may help guide your screening plan.
Elizabeth Wende Breast Care
585-758-7050
