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Positioning Challenge #1 – Adequate Pectoral (MLO View)

Kathy Willison – Senior Clinical Product & Onboarding Manager – Published on October 18, 2018

Volpara Solutions has analyzed over 1 million mammograms to identify the top positioning issues affecting mammographic quality. For the MLO view, achieving Adequate Pectoral muscle is at the top of the list of challenging positioning issues.

Why is Adequate Pectoral Important?

Adequate Pectoral muscle is achieved when the pectoral muscle angle, length, and width are captured adequately. If the pectoral muscle is not captured adequately, the result is either a narrow pectoral muscle, which indicates the potential for missed posterior breast tissue; or, conversely, a pectoral muscle with a thick axillary region, which indicates the potential for uneven compression. The thick axillary region can result in under-compression of the central and anterior breast tissue, which causes sag or droop.

Helpful Positioning Tips

To help technologists improve on challenges such as mastering an Adequate Pectoral muscle, when positioning, Volpara Solutions partnered with Mammography Educators, LLC, a leading mammography education provider, to create mammography positioning training videos. These videos are integrated in the Volpara®Enterprise™ software so that technologists can access the relevant educational resources that will help them advance their positioning and compression skills.

Some tips to achieve Adequate Pectoral muscle include the following:

  • Position the detector at the correct height for the patient to allow the pectoral muscle to relax. The top of the detector should be placed halfway between the shoulder and the axillary crease.
  • Ensure that the patient’s body is situated relative to the image receptor such that its lower corner is directly below the plane of the nipple. This presents the breast and muscle in front of the image receptor and better keeps the pectoral muscle in view.

Do you have any other positioning tips to share? Please let us know!

To learn more about how you can benefit from the breast imaging analytics and educational resources available through the VolparaEnterprise software, visit us November 25–30, 2018, at RSNA (South Hall #2565) or visit to request a demo.