RadteraAdditional Mammographic Views (Supplemental Projections)
MammoNo contrastBreast
Indications
- Problem-solving during diagnostic workup of a screening or symptomatic finding
- Confirm or exclude a finding, characterize a mass/asymmetry/calcifications, and localize
- Image tissue not optimally seen on standard CC/MLO
Patient prep
- No deodorant/powder/lotion
- Skin marker on palpable lesion or area of concern when relevant
- Performed under radiologist supervision so view selection matches the question
Contrast
None / non-contrast
Technique
- Spot compression: small compression paddle over focal area to spread overlapping tissue and confirm/dispel a summation artifact
- Magnification (M): air-gap geometry with microfocal spot to better resolve calcification morphology and mass margins
- Rolled views (RM/RL on CC): superior tissue rolled medial or lateral to separate superimposed tissue and determine lesion location
- True lateral (ML / LM): 90-degree projection for triangulation and to show milk-of-calcium layering (teacup on ML)
- XCCL / XCCM: exaggerated CC to capture far lateral (axillary tail) or far medial tissue
- Cleavage (valley) view: both breasts on detector to image deep medial tissue near sternum
- Tangential (TAN): skin-line lesion or palpable finding projected over subcutaneous fat to assess dermal vs parenchymal location
Series / Sequences
| # | Series / Sequence | Plane | Notes |
|---|---|---|---|
| 1 | Spot compression (+/- magnification) | CC/MLO/lateral | Focal mass, asymmetry, distortion, calcifications |
| 2 | Magnification | CC and ML | Calcification morphology/distribution; mass margin analysis |
| 3 | Rolled CC (RM/RL) | Craniocaudal | Resolve superimposition; localize CC-only finding superior vs inferior |
| 4 | True lateral ML/LM | 90-degree lateral | Triangulation; layering of benign calcifications |
| 5 | XCCL / XCCM | Exaggerated CC | Lateral (axillary tail) or medial deep tissue |
| 6 | Cleavage | CC variant | Deep medial / posteromedial tissue |
| 7 | Tangential | Tangent to skin | Differentiate dermal from intraparenchymal calcifications; palpable lump over fat |
Key points
- ML true lateral plus rolled views are the workhorses for triangulating a one-view (MLO- or CC-only) finding
- Magnification views are the standard for characterizing suspicious calcifications (use small focal spot)
- Spot compression that effaces a 'mass' confirms summation pseudolesion (BI-RADS 1/2)
- Tangential view with skin marker resolves dermal calcifications, sparing unnecessary biopsy
References
• ACR Practice Parameter for the Performance of Screening and Diagnostic Mammography
• ACR BI-RADS Atlas, 5th ed.
• Radiopaedia: Mammographic views / XCCL / XCCM ( link
• ACR BI-RADS Atlas, 5th ed.
• Radiopaedia: Mammographic views / XCCL / XCCM ( link
Source: Researched — verify against your institution
Reference template — verify and adapt to your scanner, vendor and institution before clinical use. Not a substitute for clinical judgment.