Repeat Mammograms for Benign Changes?

QUESTION: This year's mammogram compared to last year's showed "extremely dense fibroglandular density bilaterally." This makes "mammographic assessment less sensitive." The report also notes that "no suspicious masses or microcalcifications were identified. A benign type macrocalcification in the left breast remains stable." My HMO is not concerned and would not allow another mammogram at six-month intervals. Should I have concerns and what should I do?

ANSWER: Annual mammography at age 40 and older is the standard recommendation, unless there is an area of concern that has to be watched or evaluated more closely. Your mammography report does not seem to raise any significant concern. These descriptions—"extremely dense fibroglandular density bilaterally," "No suspicious masses or microcalcifications are identified," and "A benign type macrocalcification in the left breast remains stable"—are not worrisome for cancer. Based on this report alone, annual mammography seems appropriate. But make sure your primary care doctor, who knows you best and has performed a recent breast exam, advises you on this important issue.

—Marisa Weiss, M.D.