Hi there. So, what is your next step? Are you having a biopsy? I want to tell you that I had a birads of 5 on my very first mammogram. Scared the poop out of me. I went straight from mammo to breast surgeon. They did a needle biopsy. My issue was calcifications that were abnormal from number, spacing, surface, shape, etc. I hit all the ways they could be suspicious. I did NOT Have cancer. My results were clear. I haven't had an abnormal mammogram now in 12 years. I, like you, get 3 D mammograms now and have dense tissue. I'm sure this is worrisome but the fact that it is likely scar tissue makes perfect sense. Why it shows on one mammo vs another is that it may be newly developed. Scar tissue can build and may start out soft after implant surgery but grow harder. Tell us what happened on your follow up. hugs
Architectural distortion is a mammographic finding associated with a high positive predictive value for malignancy. It is detected more frequently on 3D mammography (tomosynthesis) than on 2D mammography and may even be occult on conventional 2D imaging.
Source: https://pubs.rsna.org/doi/full/10.1148/rg.2016150093