Spot compression

Last year I had a mammogram and because of the density of my left breast I had to have a sonogram and a spot compression, all came back normal.  This past week I received the results of this years mammogram and the same thing. The doctor who read the mammogram wants me to come back for a spot compression.  I asked why since I had both last year, I was told the doctor is very cautious and he can't see a particular area...same as last year.  I don't know if I want to go back for a spot compression because I'm concerned of the exposure to the rays of the machine twice as year, as it's turning out and shouldn't he be able to compare last years to this years mammogram?  Is it uncommon for women with dense breasts to just have the spot compression to begin with?  Thank you for your time....KAREN D

[CCF-RN,MSN-rf]

Dear Karen D:  Dense breast tissue can make mammographic interpretation difficult.  A spot compression is often recommended because there is an abnormal appearance - sometimes as simple as tissue rolled over on itself.  A spot compression can focus in on the area and help to clarify.  It is not routine for women to have spot compression to begin with but since this has happened to you twice, it may be that you can make arrangements on your next mammogram to have them interpreted before you leave so that if you need spot compression it can be done while you are there.  It depends, though on how the mammography center is run and whether the radiologist is "on site."

[surgeon]

It's hard to second-guess a radiologic recommendation, especially not seeing the films. However, it's clearly best to err on the side of caution. The amount of radiation from mammography is really minute, and it would take literally hundreds of studies to get into a range of significant concern. It is indeed more difficult to evaluate mammograms in women with dense breasts. But it's still the best screening modality out there.