Screening Mammography & The COVID-19 Vaccine

Many providers and patients are aware of newly published medical reports around unilateral lymphadenopathy found during screening mammograms in patients who recently received the COVID-19 vaccine. This subject has been showcased in the US & The Buffalo News as of late, with the suggestion that screening mammograms be put off for 4-6 weeks if patients have been administered the vaccine.

It is important to remember that at this time, this abnormality has been identified in only a very small percentage of patients who received the COVID-19 vaccine prior to their mammogram.

Based on guidance from the American College of Radiology (ACR), the Society of Breast Imaging (SBI) and our women’s imaging radiology experts, Southtowns Radiology offers the following recommendations to referring providers and screening mammography patients at this time:

We recommend NOT to delay screening mammograms

Many patients are already late in their annual screening cycle due to the pandemic. Further delay may not be in their best interest. At this time, we do NOT suggest a patient put off a screening mammogram due to a COVID-19 vaccine.

We have added additional patient questions prior to imaging

Patients seen at Southtowns Radiology will be asked if they have recently received the COVID-19 vaccine, when they received it and what arm it was administered in. In most cases, if unilateral lymphadenopathy is indicated, it is on the side that the vaccine was administered in. Notes will be added to patient records to inform the radiologist as they interpret results.

We will educate patients on the role COVID-19 may play in results

If a patient who recently received the COVID-19 vaccine shows indication of an abnormality during their mammogram, we will take extra time to talk with that patient about their results. Additional follow up mammograms and breast imaging recommendations by our radiologists will be made on a case-by-case basis.

As a designated Breast Imaging Center of Excellence, we will continue to monitor guidance from the ACR and the SBI. Should recommendations change drastically, we will update our guidance so that providers and patients can make informed decisions for their care.

Patients and referring providers who have questions regarding screening mammography appointments and the COVID-19 vaccine can contact Diana Iglewski, Women’s Imaging Manager, at 716-649-9000 ext. 244 at antime. 

COVID and Your Breast Health – Dr. Jennifer Ray with Buffalo Healthy Living

In a pandemic-clouded world, it’s easy to overlook what was once routine and to pause activities that used to be regular. But when it comes to breast health, especially during October’s Breast Cancer Awareness month, passing on your annual or first-time mammogram, is not advisable.

“Delays in screening can lead to delays in diagnosis,” said Jennifer Ray, M.D., a board-certified radiologist and medical director at Southtowns Radiology. “What we don’t want is an uptick in later-stage cancers that are more complex to treat because a mammogram was postponed.”

There are many things women can do to ensure their breast health is not overlooked as 2020 comes to a close:

Talk to your provider about where to go for your imaging services. Patients can ask and advocate to be seen at a radiology office of their choice. “Often times women go to a particular imaging center because that’s where their practitioner sends them but it’s not always the most convenient option,” commented Dr. Ray. “Patients can ask to be seen at an imaging center of their choice – one that accommodates their needs and is close to home, work or school.”

Tune-up your breast health knowledge. One in eight women will be diagnosed with breast cancer and it’s anticipated that over 1,400 new cases of breast cancer will be diagnosed across the eight counties of Western New York in 2020 alone (New York State Department of Health Cancer Data). Three out of four women who are diagnosed have no known risk factors, and no family history of breast cancer.

“We see too many women who say ‘Breast cancer doesn’t run in my family or I was tested and am not a BRCA/BRCA2 carrier,” remarked Dr. Ray. “In reality, those with family history make up just a small percentage of women who receive a breast cancer diagnosis. And early detection always provides the best chance for a positive outcome.”

Women who do have a family history should be especially mindful of keeping regular screening appointments and of talking with their providers about any changes in their breast. The right imaging center can detect even the smallest changes in the breast early, and being proactive about your breast health can ensure you get early and appropriate care.

Research your imaging center’s technology. In recent years, there have been regular advances in screening capabilities for breast imaging. In today’s world, patients should verify that their imaging provider uses 3D mammography as their standard. 3D mammography, also known as digital breast tomosynthesis, allows radiologists to see smaller abnormalities sooner, especially in women with dense breasts or those with fatty breast tissue.

“Studies have credited 3D mammography with detecting 41% more invasive cancers in women of all breast tissue types,” noted Dr. Ray. “When talking with your primary physician, it’s good to ask if the imaging center is using the latest technology. Patients can also ask when making an appointment.”

Southtowns Radiology is an accredited Breast Center of Excellence by the American College of Radiology (ACR), and offers 3D mammography, breast ultrasound, MRI, as well as diagnostic imaging and biopsy. 

Conveniently located in Hamburg and Orchard Park NY, they offer early morning, evening, and Saturday appointments. For more information or to schedule a mammogram, call 716.649.9000.

Jennifer Kam Ray, M.D. is the Medical Director of Southtowns Radiology. She is board certified in radiology and provides additional expertise in pelvic MR, ultrasound and breast imaging.

Dense Breasts on Mammogram? Don’t Be Afraid

The first thing to know is that if you’ve been told that you have dense breast tissue, you are in good company. Approximately 40-50% of women in the U.S., aged 40-74, fall into that category.

But what does the word “dense” really mean?


On a mammogram, non-dense breast tissue appears gray and transparent. Dense breast tissue appears as a solid white area on a mammogram, which makes it difficult to see through. Dense breast tissue makes it more difficult to interpret a mammogram since cancer and dense breast tissue both appear white on a mammogram. Very dense breasts may increase the risk that cancer won’t be detected on a mammogram. Still, having dense breasts does not mean you have a tumor or that you will get breast cancer. For the majority of women, it primarily means patients and their physicians will need to take some additional care and consideration in future screenings.


Breast density is determined by the radiologist who reads your mammogram. Breasts are measured in four categories of denseness, one being compromised almost entirely of fatty tissue and four being extremely dense.

At Southtowns Radiology, we use VolparaDensity, a software to more accurately categorize breast density into the four categories defined by the American College of Radiology. This computer algorithm calculates breast density automatically based on your mammogram scan. The advantage is that you will always get the most consistent picture of your breast density, with no possible variations from one doctor to the next. Knowing what category your breast density falls into helps determine what additional screening options are best for you.


3D mammography is especially recommended for women with dense breasts, however, multiple studies have found that it detects 41% more invasive cancers in women of all breast tissue types. Southtowns Radiology recommends that women with both dense or with fatty breast tissue consider 3D mammography for their screening exam.

For patients with dense breast tissue, we recommend the addition of a breast ultrasound to your annual screening regiment. An ultrasound uses sound waves to travel through the breast tissue and unlike a mammogram it is not limited by breast density. There is no radiation, it is essentially pain-free and serves as a useful tool if used in conjunction with a mammogram. If having an ultrasound will reassure you that you’ve done everything you can to screen for breast cancer then ask your ordering doctor to order you a breast ultrasound in addition to your screening mammogram.

In conclusion, knowing what dense breast tissue means can help women understand and take advantage of the variety of screening methods available. Knowledge is protection.

At Southtowns Radiology, our highly trained technologists take pride in offering the best imaging along with the best possible experience for every patient they care for. Schedule your mammogram today.

Breast Cancer Screening Legislation

As of January 1, 2017 New York State is taking the most aggressive action in the nation to improve access to breast cancer screening with a new law requiring health insurance to cover all screening and diagnostic imaging exams for the detection of breast cancer.

The Law:

  • Includes supplemental imaging for women with dense breast issue.
  • The first law in the country requiring insurance companies to cover all of the costs of supplemental imaging to encourage women with dense breasts to seek additional screenings.
  • Eliminating these insurance barriers will prevent women from paying out-of-pocket for breast cancer screening, including imaging for the detection of breast cancer, diagnostic mammograms, breast ultrasounds, or magnetic resonance imaging.

*In 2013, New York was the first state to adopt a dense breast notification law to inform patients in clear, unambiguous language if their mammogram showed high fibroglandular densities.


Southtowns Radiology Breast Cancer Survivor Series – Libby’s Story

“I was lucky that I was diagnosed so early.”

Six-year survivor Libby had always been practical when it came to managing her risk for breast cancer. Several of her family members (including aunts, a cousin and her sister) had been diagnosed, so she knew she needed to be vigilant.

In addition to regular screening mammograms, Libby also had a BRCA gene test performed to determine if she carried an inherited mutation that would further increase her risk. “I knew I fit the profile, so I wanted to be proactive,” stated Libby.

Although her genetic testing came back negative, those results proved to offer no protection. In 2010, her radiologist found an area of suspicion during a routine mammogram at Southtowns Radiology. “A friend actually performed my mammogram,” Libby recalled. “She was so sweet when she told me they needed more images, but I figured there was a problem. Thankfully, they caught it early so I didn’t need radiation or chemotherapy.”

After careful consideration, Libby chose the most radical treatment option: a bilateral mastectomy with reconstruction. “I had breast cancer. All I wanted to know was what to do so that I could move on,” she said. “I opted for a bilateral mastectomy, because it gave me a 99% chance of being cured.”

Unfortunately, Libby’s body rejected the implants that were part of her reconstruction – and they had to be removed. But while some would’ve been devastated, she remained extremely positive. “Reconstruction is a very personal choice,” Libby declared. “It’s up to each woman to decide what makes her feel best.”

Throughout her recovery, Libby stayed strong by becoming active volunteer, fundraiser and organizer for several organizations including the American Cancer Society and the Susan G. Komen Foundation. “I did it to take the focus off myself and put it someplace productive,” Libby stated.

Libby considers herself extremely fortunate to have been diagnosed so early, and she’s found a silver lining to becoming a cancer survivor. “At first, I didn’t really talk about my cancer – my co-workers didn’t even know why I took off work,” she reflects. “Once I got involved with my volunteer work, though, I started to become more comfortable talking about it. People started approaching me wanting to share their stories. In the process, I realized that I can be a real support for others – it’s sometimes hard for patients and survivors to open up to their families.

“Cancer has made me more eager to live, and I welcome new experiences,” she continued. “I kind of let more things roll off my back now – little things aren’t that important. What is important is being with my family and friends. They mean everything to me.”

When asked about the advice she’d give to others regarding breast cancer, Libby offered the following: “The minute a girl becomes a woman, she needs to talk to her family doctor and needs to be 100% responsible for her body,” Libby said. “I’d also tell people that just because you have a breast cancer gene, it’s not a death sentence. It’s knowledge you can use to be proactive.”

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Southtowns Radiology Breast Cancer Survivor Series – Johanna’s Story

“What am I going to tell the women in my life?”

This was the first thought that entered Johanna’s mind when she was diagnosed with invasive ductal carcinoma on February 28, 2014. Instead of worrying about herself, she was more concerned with the worry she would put on her family – particularly her mother, sisters and 14-year-old daughter.

The past 24 hours had been a whirlwind for Johanna. She’d called Southtowns Radiology at around 8:00 a.m. just one day earlier, saying that she’d found a lump in her breast. They asked if she could be there by 8:40, setting in motion a series of events that would forever change her life.

“I had actually found a lump in my breast a few days earlier while leaning across my desk, but it was so low that I thought there was no way it could’ve been breast cancer,” said Johanna. “Having had lap-band surgery a few years earlier, I honestly thought that the band had become dislodged. I scheduled the mammogram to rule out the possibility of cancer before contacting my gastric surgeon.”

When she arrived at Southtowns, they saw her immediately. After a mammogram and sonogram revealed two areas of suspicion, the nurse coordinated with Johanna’s doctor to arrange an immediate biopsy.

Despite undergoing an increasingly invasive series of tests that she knew might lead to a cancer diagnosis, Johanna managed to maintain her composure. “The nurse at Southtowns was amazing. When she found out that I needed additional testing, she dropped everything and stayed by my side the entire time,” Johanna stated. “I’m prone to anxiety, but she and the radiologist kept me calm and the atmosphere light under difficult circumstances. Instead of letting me go home to worry while I waited for biopsy results, they sent me right to my doctors’ office, images in hand, to see a breast surgeon.”

Before parting ways that Thursday, the nurse asked if there was anything she could do for Johanna. “Yes,” she said, “You can call me and give me my diagnosis over the phone as soon as you know. Whether the news is good or bad, I don’t want to wait for a doctor’s appointment to find out.”

The call came the very next day.

“Having already talked in detail with my husband and son, when I received the news, I thought, ‘How do I break my daughter’s, my mother’s, my sisters’ hearts by telling them that I was sick – and might get sicker – and worse, they could be next?'” Johanna reflected. “I wasn’t worried about myself – I’m a fighter; I was more concerned about the toll this would take on these ladies. This was going to change their world forever.”

Her tumors needed to be shrunk via chemotherapy before surgery was performed. Thankfully, Johanna’s lesions responded well to the chemo and she underwent a bilateral mastectomy with reconstruction. When her surgical pathology indicated the presence of cancerous cells, Johanna followed her doctor’s recommendation to undergo radiation therapy. “I wanted to be able to tell myself that I did everything possible to ensure the cancer wouldn’t come back,” she said.

Through it all, Johanna was thankful for the support she received from her family, friends and employees. The owner of several Merry Maids franchises, she stayed strong during her treatment and recovery by keeping her schedule as normal as possible. “My mindset was, ‘If I miss a day of work, I’m letting cancer win,'” Johanna continued. “I worked all through my chemo and didn’t miss a day until I had surgery. Thankfully, I have an amazing group of employees who did a great job taking care of the business when I was out. They took that stress away from me.”

When she realized she would lose her hair from chemo treatments, Johanna didn’t feel sorry for herself. Instead, she gave her hair a “going away” party by dyeing it purple and taking a trip to Punta Cana with her husband, son and daughter.

“Cancer has made me a better person,” said Johanna. “Superficial things aren’t as important to me. The people who are in my life now are the ones who really matter. Plus, I have a new circle of friends who have been through the same thing as me. We don’t get together and whine about what’s happened, but we do have a powerful connection that bonds us.” And difficult circumstances aside, Johanna is also very pleased with her reconstruction results.

Johanna’s story is like many other cancer survivors’: despite routine mammograms and regular self-examination, the discovery of her lump was almost accidental. Thankfully, Johanna listened to her intuition and was worked up and diagnosed immediately.

When asked what advice she’d give to other women about breast cancer or screening, Johanna shared this: “As soon as you think something MIGHT be wrong, get it checked,” she stated. “It’s better to be checked 10 times and told that it’s nothing, than to wait and be told it’s much worse than it could’ve been, had you been checked immediately.

“At work, we’re really open about discussing breast cancer; we provide pink t-shirts to the staff and have our own awareness campaign,” Johanna continued. “I even talk to my male employees about it, using a baseball analogy: when you’re ‘sliding into second,’ make sure there are no ‘rocks’ on the infield. In other words, breast examination is both a woman’s AND her partner’s job.”

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Southtowns Radiology Breast Cancer Survivor Series – Lisa C.

Southtowns Radiology Breast Cancer Survivor Series – Lisa’s Story

“This is kind of weird.”

That’s what Lisa C. said to her husband, after finding a lump in her right breast while showering. She wasn’t overly alarmed; her last mammogram was clear, and she performed regular self-examinations.

But her intuition told her to go get it checked immediately.

And she’s so glad she did.

Just a few days later, Lisa was examined by her OB/GYN, who scheduled a mammogram and sonogram at Southtowns Radiology for the following day. Based on the findings, her doctor ordered a biopsy. “The procedure wasn’t painful at all,” said Lisa. “And at that point, we were all hoping the lump was just a cyst. I do have a history of breast cancer in my family, but I still didn’t think it could happen to me.”

At 3:50 on Friday, July 8th, the call came: Lisa had invasive ductal carcinoma, and she knew immediately that her life would never be the same. “I had just gotten home from work when I received my diagnosis, and I was in a mixed state of disbelief and terror,” she said. “A million questions flooded into my head. I thought, ‘How could this be happening to me? What have I done that was so bad that I deserve this? What is my son going to do without a mother?'”

After she shared the news with her husband and her initial panic subsided, Lisa knew she had to steel herself for an incredibly difficult journey. She reassured herself by recalling how her mom, aunt and cousin had survived breast cancer. “If they could do it, I knew that I could, too,” she thought. “For me, there was no ‘Option B’; I just couldn’t give up, because I had family depending on me.”

Lisa needed a second biopsy, to rule out the possibility of lymph node involvement. “It was pretty scary, but the staff at Southtowns took great care of me,” she stated. “They never let me walk out of there questioning; they were proactive with my care and did whatever was needed to make sure I had the information to feel confident with my diagnosis, prognosis and treatment regimen.”

Thankfully, she received good news that her cancer had not spread. Subsequent testing confirmed that she did not carry the breast cancer gene, which meant that she would not undergo a bilateral mastectomy. With that reassurance, she was prepared to begin her treatment: a lumpectomy with sentinel node removal, followed by chemotherapy and radiation.

Lisa’s surgery was successful, and she’s just beginning her chemo regimen: four rounds of Adriamycin with Cytoxan, followed by 12 weekly Taxol infusions. All told, she’ll undergo five months of treatment.

When asked what advice she’d give to other women about breast cancer or screening, Lisa was adamant. “Be your own advocate,” she stated. “Check yourself in the shower regularly; lathering up really does make self-examination easier.

“Always listen to your body and mind,” she continued. “As a woman, you have the ability to know what’s going on with your body. If anything seems out of the ordinary, go for that extra mammogram or biopsy. I’m so glad that I went with my women’s intuition.”

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October Is Breast Cancer Awareness Month

Breast Cancer Awareness Month

Life-saving screening for early breast cancer detection should be a top priority for all women. The majority of healthcare providers agree the key to saving thousands of lives every year is early detection of breast cancer through breast cancer screening.

Early Detection Is Critical

The best way to combat breast cancer is to have a comprehensive screening plan. Catching the disease in its infancy involves screening exams for women before they have symptoms. Early screening allows breast cancer to be detected sooner than it otherwise would have been noticed; before the disease causes symptoms such as noticeable lumps. Sadly, breast cancers that are diagnosed following the presence of symptoms tend to be larger and more extensive than those found at routine screening. Breast cancers found thanks to early screening typically turn out to be smaller and confined to breast tissue.

Main Factors

The size and distance cancer has spread are the two most critical factors when determining patient prognosis. And according to the American Cancer Society, the five-year survival rate is nearly 100 percent when localized breast cancer is found early.

Early Detection: How To

The American College of Radiolgy recommends the following breast cancer screenings:


Self breast exams are recommended monthly start at the age 20.

Clinical Exam

Women between the ages of 20 and 39 should have a clinical breast exam, once every year to three years to detect possible signs of breast cancer. Women over the age of 40 should have a clinical exam done by a healthcare professional annually.


Baseline mammogram at age 35 and every year for women 40 years and older. Mammograms can detect breast cancer nearly two years before the presence of a physical lump. Women 30 years or older, who are at higher risk of a breast cancer diagnosis, are recommended to have mammograms annually.

No Family History of Breast Cancer: Do You Still Need a Mammogram?

Yes. Three out of every four women who receive a breast cancer diagnosis have no family history of the disease. Regular breast cancer screenings that include mammograms can help detect cancer early. Even if you have no family history of breast cancer, are in excellent health and have an ideal body weight, annual mammograms can save your life.

Mammograms in Western New York

Fitting a mammogram and other breast screenings into your busy schedule doesn’t need to be difficult. With locations in Hamburg and Orchard Park, the breast cancer detection specialists at Southtowns Radiology make it easy for you to get the life-saving screening you deserve. Contact them today to schedule your appointment.

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Breast Cancer Awareness Month Infographic

October is Breast Cancer Awareness Month. All throughout the month, Southtowns Radiology will be sharing great information about the importance of early screening and detection.


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3D Mammography at Southtowns Radiology

Hologic 3D Mammography at Southtowns Radiology Significantly Increases Cancer Detection

July 17, 2015

Southtowns Radiology is excited to offer Hologic Genius 3D Mammography for breast cancer screening.  3D mammography produces a three-dimensional view of the breast tissue that helps radiologists identify and characterize individual breast structures without the confusion of overlapping tissue.

In the June 25, 2014 issue of the Journal of the American Medical Association (JAMA), a groundbreaking study was published that found Hologic’s 3D mammography (breast tomosynthesis) screening technology significantly increased cancer detection while simultaneously reducing the number of false positives.

The study, “Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography”,  that reviewed close to half a million mammography exams, was led by Sarah M. Friedewald, MD of the Caldwell Breast Center, Advocate Lutheran General Hospital in Park Ridge, Illinois.1 The researchers found that 3D mammography finds significantly more invasive or lethal cancers than a traditional mammogram. According to the study’s results, 3D mammography also reduces the number of women called back for unnecessary screenings due to false alarms.  That reduces anxiety, as well as health care costs.

Significant findings include:

  • A 41% increase in the detection of invasive breast cancers. (p<.001)
  • A 29% increase in the detection of all breast cancers. (p<.001)
  • A 15% decrease in women recalled for additional imaging. (p<.001)
  • A 49% increase in Positive Predictive Value (PPV) for a recall. (p<.001)
  • A 21% increase in PPV for biopsy. (p<.001)
  • No significant change in the detection of ductal carcinoma in situ (DCIS).

This study, using Hologic 3D mammography systems, involved 13 U.S. breast screening sites and 139 radiologists.

The center’s Selenia® Dimensions® 3D mammography system is made by Hologic, a world leader in digital mammography. The Selenia Dimensions system offers exceptionally sharp breast images, an advanced ergonomic design providing more patient comfort, and the ground-breaking Hologic Genius 3D Mammography platform designed to deliver superior screening and diagnostic performance for all breast types. 2

We believe Hologic Genius 3D Mammography will benefit all screening and diagnostic mammography patients, and is especially valuable for women receiving a baseline screening, those who have dense breast tissue and/or women with a personal history of breast cancer.

The Hologic Genius 3D mammography screening experience is similar to a traditional mammogram. During a 3D mammography exam, multiple, low-dose images of the breast are acquired at different angles.  These images are then used to produce a series of one-millimeter thick slices that can be viewed as a 3D reconstruction of the breast.

By offering women the latest and more accurate3 technology in mammography, Southtowns Radiology expects to increase the number of area women who will be routinely screened.  Breast cancer is the second leading cause of cancer death among women, exceeded only by lung cancer. Statistics indicate that one in eight women will develop breast cancer sometime in her lifetime. The stage at which breast cancer is detected influences a woman’s chance of survival.  If detected early, the five-year survival rate is 98 percent. 4

Southtowns Radiology is committed to the fight against breast cancer. In offering Hologic 3D mammography, Southtowns Radiology provides the latest in imaging technology. If you would like to schedule a mammogram or have questions about this important breast health procedure, please contact our office at 716-649-9000 or visit our Mammography page for more information.


1  Friedewald SM, Rafferty EA, Rose SL, Durand MA, Plecha DM, Greenberg JS, Hayes MK, Copit DS, Carlson KL, Cink TM, Barke LD, Greer LN, Miller DP, Conant EF,  Breast Cancer Screening Using Tomosynthesis in Combination with Digital Mammography, JAMA June 25, 2014.

2 Rafferty E, Park J, Philpotts L, et al. “Assessing Radiologist Performance Using Combined Digital Mammography and Breast Tomosynthesis Compared with Digital Mammography Alone: Results of a Multicenter, Multireader Trial.” Radiology. 2013 Jan; 266(1):104-13. Epub 2012 Nov 20.

3 Zuley M, Bandos A, Ganott M, et al.  “Digital Breast Tomosynthesis versus Supplemental Diagnostic Mammographic Views for Evaluation of Noncalcified Breast Lesions.”  Radiology. 2013 Jan; 266(1):89-95. Epub 2012 Nov 9.

4  Breast Cancer Facts & Figures 2011, American Cancer Society.