What does this current mammogram result mean? within the mid slightly outer right breast, there are two adjacent nodular asymmetries. they appear superficially located my 2017 mammogram had no mention of this?

You will likely need further test such as ultrasound or MRI for those new findings. There is nothing to worry at this point. Good luck.

At age "48", and not on oral birth control (which are given to stop ovarian hormone production and lessen symptoms of pre-menopause) , fibrocystic changes in breast tissue may show on mammography as nodular areas. This would statistically increase in the time after 2017, and w/o areas of fine calcium deposits, they do not portend cancerous changes.