I would definetly get an ultrasound with each and every mammogram. I would also insist on a digital mammogram because you have dense breasts. I also have them and I've read many articles while sitting there during my chemo treatments that say that we have an increased risk for breast cancer because of the dense breasts. Dense breasts show up white on a mammogram and so does cancer.
An ultra sound found my cancer finally, not the mammogram, but the MRI showed just how large it really was. I don't know why you feel you have to go on hormones but I'm sure you have your reasons. I personally would not take any HRT even though I certainly could use the benefits they would provide. I just don't want cancer again. My cancer was ER/PR positive 90%.
Best of luck to you :)
I also have dense breast (parenchyma) tissue which first showed up in a mammogram that I had 10 years ago. Apparently, it's not an uncommon condition as many women have dense and fibrocystic breasts. But, it's a condition that can make a mammogram a bit more difficult to interpret. If an abnormality was detected in your recent mammogram,
you would have been sent to have the diagnostic tests that you mentioned.