Author: Elizabeth Wende Breast Care


On average close to 50% of women have dense breast tissue identified on mammography. Having dense breast tissue makes it more challenging to find breast cancer on a mammogram as the dense tissue is white and breast cancer can hide within this tissue. In addition, having dense breasts is considered an independent risk factor for breast cancer and raises the risk of that patient developing breast cancer. Although New York State has a law to inform all patients having a mammogram of their breast density since 2013, still, few women are aware that having dense breasts is a significant risk factor for breast cancer.

Thirty-eight states require that women receive written notification (Breast Cancer Notification Rule) about their breast density and potential breast cancer risk after a mammogram. The wording of breast density notification varies from state to state. However, many states do not currently have a requirement to notify patients of their breast density, cancer risk, or the importance of talking to a healthcare provider about their breast density.

Recently, Congress revealed the Breast Density and Mammography Reporting Act that directs the Food and Drug Administration (FDA) to issue a national reporting standard requiring all mammography reports to include an assessment of breast density. The FDA recently announced a national reporting standard requiring mammogram reports to include breast density information, which will go into effect on September 10, 2024.

Under the new rules, women in every state will receive a written notice informing them of their breast density status. Patients will be told if they are DENSE or NOT DENSE and advised to speak with their health care provider about their results. Patients having a mammogram examination in every state will have information and education about their breast density. In addition, patients with dense breasts may be eligible for additional screening tools such as ultrasound and MRI. Elizabeth Wende Breast Care (EWBC) offers screening breast ultrasound for patients with dense breast tissue at all seven of our facilities. Breast MRI is offered in Brighton (our original office).

EWBC is proud to know those who have advocated for this change and remain committed to the early detection of breast cancer. (For more information:

Katie Couric used her diagnosis to advocate and strengthen breast cancer awareness, especially among those with dense breasts. A Federal bill was introduced in Congress with Katie Couric on December 12, 2022, called the “Find It Early Act,” which will require all insurance plans, including Medicare, to cover screening and diagnostic breast imaging with no out-of-pocket costs for women with dense breasts or at higher risk for breast cancer. Included are mammography, breast ultrasound, and breast MRI.

The overall goal of the Find It Early Act is to reduce the number of cancer-related deaths in the US by promoting early detection and prevention measures, improving access to screening and diagnostic tests, and increasing public awareness about the importance of early detection and prevention.

To find out more or to support the “Find It Early Act”:




Technology Matters: How Expert Radiologists Use AI to Enhance Breast Cancer Detection

A routine mammogram appointment at Elizabeth Wende Breast Care (EWBC) may seem like a simple exam. However, we utilize an incredible amount of technology in the background to benefit our patients.

There have been many technological advancements in breast cancer detection over the last 50 years. EWBC has been at the forefront of these advancements and continues to investigate and research the newest technology for the benefit of our patients.

The latest buzz in the medical community is using artificial intelligence (AI), specifically artificial intelligence, to interpret radiology exams, such as a mammogram. There are several AI programs available on the market today. However, these programs are not standardized or endorsed by the American College of Radiology (ACR) as a replacement for the expertise of a breast imaging radiologist- the doctor reading your mammogram.

EWBC uses AI in many ways, such as determining breast density (2013), performing cancer risk assessment (2010), and computer-aided detection (CAD,1997). The AI technology we use has been carefully selected to fit the needs of our patients and is complementary to our breast imaging experts.

So, the question remains—will AI replace the radiologist in interpreting mammograms? The answer, at least at EWBC, is no. EWBC is unique because two breast imaging experts read every screening mammogram. Our radiologists read thousands of mammograms each year, and studies have proven that the more radiologists read, the better they are at detecting abnormalities—consistently outperforming artificial intelligence.

Artificial intelligence is a tool to enhance clinical care but should not be used as a stand-in for the expertise of breast imaging specialists. We use versions of AI to determine breast density, cancer risk, and computer-aided detection. Utilizing technology allows us to create individualized results for every patient- much more than just a mammogram.

Dr. Destounis attends RSNA Meeting in Chicago

Just after Thanksgiving every year, Dr. Stamatia Destounis of Elizabeth Wende Breast Care (EWBC) heads to The Radiological Society of North America (RSNA) Annual Meeting in Chicago, IL. She has been dedicating this week to the meeting for more than 30 years. RSNA promotes excellence in patient care and health care delivery through education, research, and technological innovation. This international radiology meeting is a group of the greatest minds in all areas of radiology, including breast imaging. Dr. Destounis will present on various breast imaging topics throughout the week.

On Monday, 11/28, Dr. Destounis will be representing the USA in “Challenging Breast Cases: A Game Show USA Versus Europe,” which is an image interpretation quiz focused on breast imaging cases in a competitive format. A group of junior and senior breast imaging experts, as well as the respective presidents from the Society of Breast Imaging (SBI) and the European Society of Breast Imaging (EUSOBI), will ‘clash’ in a friendly contention. Based on clinical information and images, intermediate and expert breast cases will be discussed and solved.

Later Monday afternoon, she will moderate a session on breast abstracts related to the topics of breast density and supplemental screening. Tuesday 11/29 Dr. Destounis is leading two ultrasound biopsy workshops in which attendees learn the ins and outs of performing a breast needle biopsy under ultrasound guidance. Wednesday, 11/30, Dr. Destounis will be presenting BI-RADS (Breast Imaging Reporting and Data System) updates they have been working on for over a year.

Lastly, on Thursday, 12/1, Dr. Destounis will present her abstract on the performance of digital breast tomosynthesis in women with dense breast tissue. A busy week for Dr. Destounis!

How to Pick a Breast Center

  • You’ve probably heard you should get an annual mammogram starting at age 40. However, most women don’t know where to start when it comes to selecting a breast care center. Here is a checklist when choosing a breast center.
    A breast imaging center with a team of experienced breast imaging specialists
    3D mammography with synthetic 2D for every patient —
    reducing overall radiation dose
    Two expert opinions to give you peace of mind
    Cancer Risk Assessment for every patient to determine
    the lifetime risk of breast cancer
    Professional & supportive staff to guide you through your visit

October is Breast Cancer Awareness Month: Don’t Ignore Your Own Health

Dr. Lisa Paulis reminds women not to ignore their own health while busy taking care of others. Preventative cancer screenings are important. Early detection is key.

Dr. Paulis talks with Channel 13 WHAM Rochester:

“I would say that women are natural caregivers, and they tend to take care of everybody around them and prioritize their own health last, and we would not recommend that,” said Dr. Lisa Paulis, a radiologist at Elizabeth Wende. “Having mammograms and taking care of yourself is really taking care of your family. Talking to your doctor about the appropriate time to screen, based on your risk, is a conversation everyone should be having with their primary care physician.”

Watch the WHAM news story




Are you dense? Do you need an ultrasound? 

Are you dense? About 50% of women over 40 have dense breasts and are at higher risk for breast cancer. Ultrasound improves detection for women with dense breasts.

Katie Couric recently shared her story of early detection and revealed she had an ultrasound with her mammogram because of her dense breasts. Since her story came out, our phones at Elizabeth Wende Breast Care have been ringing with lots of questions regarding breast density.

Keep in mind

  • Breast density is determined by your mammogram and will be indicated on your mammogram report. Know your breast density
  • Density can change over time as it may be different from year to year
  • Ultrasound is beneficial for women with dense breasts because dense breast tissue is more difficult to see on a mammogram alone

Examples showing breast density types on a mammogram, Dense breast tissue may hide small cancers

Each time you have a mammogram, your radiologist reviews your breast density for two reasons

  • Dense breasts have a higher chance of developing breast cancer
  • It is more difficult to find breast cancers in dense breasts compared with fatty breasts. The dense breast tissue shows up white on a mammogram and may hide cancer and other abnormalities, making the mammogram more difficult to read

For these reasons, most states, including New York, require that radiologists include your breast density with your mammography results

If you want to know your breast density, please refer to your most recent mammogram report. Your reports are available on the patient portal, EWBC APP, or give us a call at 585-442-2190


Watch our videos on breast density

Mammogram Minute: Are You Dense? Who Needs an Ultrasound? (Dr. Stamatia Destounis explains)

What is breast density?


Do I Need An MRI?

Magnetic Resonance Imaging or MRI is a highly sensitive, noninvasive diagnostic tool often used in conjunction with mammography and ultrasound. It helps physicians evaluate the extent of breast cancer, as well as establish a treatment plan and monitor a patient’s response to chemotherapy. This advanced technology is also a valuable screening tool for patients considered to be at high risk for breast cancer, whether due to strong family history, genetic risk, personal history, or other risk factors.

MRI is an advanced, state-of-the-art medical imaging method. Breast MRI uses a powerful but harmless magnetic field and radio waves to produce detailed images of the breast and its internal structures. No radiation is used for MRI imaging.