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Positioning Challenge #2 – Inframammary Fold Obscured (MLO View)

Kathy Willison – Senior Clinical Product & Onboarding Manager – Published on October 25, 2018

Second on our “top hits” list of positioning challenges for the MLO view is visibility of the inframammary fold (IMF).

How Do I Achieve a Visible IMF?

Visible IMF is achieved when the inframammary fold is visualized and open. If the IMF is not well demonstrated, there is a greater likelihood that posterior-inferior breast tissue will be omitted from view.

Helpful Positioning Tips for Technologists

Our partners at Mammography Educators, LLC have provided the following tips to achieve a Visible IMF:

  • Stand perpendicular to the patient, on the medial aspect of the breast being imaged. This provides the best access to the breast and allows you to keep eye contact with the patient.
  • Once the breast is lifted to bring it onto the image receptor, you will have the greatest success if you can keep your hand in contact with the breast, sliding your hand down and around to the front of the breast in one quick motion. This keeps the breast in contact with the image receptor alleviating posterior Lower Outer Quadrant (LOQ) folds, which typically close the IMF, and allows the breast to be lifted up and out to present the IMF in view.
  • Finish the motion by sliding the base of your thumb towards the nipple with the fingers pointed to the upper corner of the image receptor to further open the IMF.

Improving Quality

Having access to this type of mammogram analysis for every single image allows the technologist to conduct a self-assessment of positioning and compression techniques. Furthermore, having access to educational resources allows each technologist to proactively address any challenging areas.

For example, St. Luke’s Hospital in Maumee, Ohio, has improved its team’s overall quality scores each month with 82% of technologists displaying a positive trend since they started using VolparaEnterprise software as a key component in their quality improvement program.

If you would like to learn more about Actionable Breast Imaging Analytics, visit us November 25–30, 2018, at RSNA (South Hall #2565), or visit to request a demo.