mri following mammogram

[chayahindy]

i am 35 yrs old and had a baseline screening mammogram.  i needed to have a follow-up bec. of "density" with repeated mammograms of specific spots done with a "paddle" and then ultrasound.  the radiologist said the ultrasound was fine, and although the dense area dispersed with compression, she still wanted me to follow up with an mri.  is this a regular occurrence and how nervous should i be? (recently stopped breastfeeding, about 6 weeks ago and i don't know if this is contributing)

[CCF-RN,MSN-rf]

Dear chayahindy:  It is not unusual for densities to be identified on a screening mammogram and then "clear" with spot compression. It sounds reassuring that the area disappeared with compression and was not seen on ultrasound.

Breast MRI is not used for routine breast cancer screening, but clinical trials (research studies with people) are being done to determine if MRI is valuable for screening certain women, such as young women at high risk for breast cancer. MRI cannot always accurately distinguish between cancer and benign (noncancerous) breast conditions. Like ultrasound, MRI cannot detect microcalcifications.

MRI is used primarily to evaluate breast implants for leaks or ruptures, and to assess abnormal areas that are seen on a mammogram or are felt after breast surgery or radiation therapy.  It can be used after breast cancer is diagnosed to determine the extent of the tumor in the breast. MRI is also sometimes useful in imaging dense breast tissue, which is often found in younger women, and in viewing breast abnormalities that can be felt but are not visible with conventional mammography or ultrasound.

[surgeon]

It's pretty common to find "spots" on mammogram that require additional viewing to be sure. In a woman who was nursing so recently, that's especially true. Some people would say that since it didn't show on ultrasound and got more faint on compression, that that's enough. When to go to MRI is a judgement call; sometimes it adds useful info, sometimes it doesn't.