Asymmentric/focal density .... Questin

I recently went for a screening mammogram. I go every two years. I get the dreaded call back for further diagnostic imaging. This letter said I have a BREAST DENSITY: BIRADS D.

Now I always knew I had cystic breasts, I have had many biopsied and turned out to be nothing. I also went in for a lump under my breast once, doc thought it to be a sebaceous cyst but sent me to ultrasound where they found 3 masses. Surgically I had these removed. B9.

But this is the first time I was informed of my breast density. The most bothersome thing I researched was that mammography in dense breasts like mine...does NOT pick up 50% of the cancers. So lets toss a coin! I'm very disturbed I was never informed of this as I will be 53 this month. So to me this was not good.

I await my diagnostic testing appointment. I'm thinking I'm going back because I have dense breast tissue and really was not worried about it. So I get in and they start with my left breast. Once finished she said that I could get dressed. I replied...well aren't you doing the other breast as I do have two dense breasts. She replied NO. There was only a concern for my left breast. I was then sent for an ultra sound. Suddenly they got my full attention.

Went to Doc to get results. He starts with 1 in 8 women will get breast cancer. Said I had a "thickening". Said I am not out of the woods yet and they will watch closely and re-evaluate in 6 months.

I asked about a biopsy and he said I would have to convince a surgeon to do it. I then asked about my private options. Subsequently we have arranged a private MRI, not cheap, but totally going to be worth it I think. My anxiety right now is through the roof. So we are now waiting for my period and then will schedule it optimally for hormones. Tentatively August 24, 2019. I tell you this is the first time I can hardly wait for my period to come.

So my report says: (my question follows)

COMPARISON: 21 MARCH 2011 AND 22 JUNE 2017 (This is a good thing I found out that there is a comparison)

TECHNIQUE: MLO and CC views, of the left breast...Cone mag compression views in CC and MLO projects.

BREAST COMPOSITION: C- The breast(s) is/are heterogeneously dense, which may obscure small masses. (on the Screening mammogram it said BI-RADS D)

FINDINGS: The workup images confirm the presence of a focal area of increased density in the posterior inferior left breast showing mixed unit and fat density with poor margination. This shows slight increased conspicuity when compared to 2017 and is not identified on the fil screen image 6 of thousand 11.

The patient shows characteristic of small island of breast parenchyma.

IMPRESSION: Asymmetric density confirmed without a discrete focal mass lesion. The appearance is not strongly suspicious for malignancy or significant breast pathology and has characteristics compatible with an island of breast parenchyma.

This has however shown interval increase in conspicuity since 2017. Although this could relate to menstrual cycle effect, short interval follow-up is recommended with repeat examination of the left breast diagnostic facility in 6 months time to assess stability.

BI-RADS 3 - Probably Benign. Short interval follow-up recommended. (my research tells me this is less that a 2% chance of being Malignant).

So this is my question: A developing Asymmetry - Is a focal asymmetry that is new, larger, or more conspicuous when compared to prior studies. Of these, approximately 15% - 27% are found to be malignant. So mine has increased in conspicuity, this is new to me...this also is greater than a 2% chance of a BI-RADS 3 and should be a BI-RADS 4, which MUST be biopsied. Is this an error as I suspect and I should be getting this biopsied?

I have read so much and I am fully aware that it could be b9 however in research, invasive lobular carcinoma and ductal carcinoma can also a small appear as a island of breast parenchyma. What frightens me is all the things over my screening history that the mammogram has missed. If I had known this I would have been screening with MRI a long time ago.

Regardless of my MRI results I will convince a surgeon to take this tissue out for this reason alone. Looking for other peoples thoughts on this. Thank you.