[Mammographic positioning: how does it affect the gynecologist?].

High quality in breast imaging is of utmost importance for early diagnosis of breast cancer. Conventional x-rays are usually taken in 2 perpendicular views. This technique allows precise spacial localization of pathologic findings. Since 1983 mediolateral oblique (MLO) instead of mediolateral (ML)-projections have been recommended because they supposedly include more of the axillary tail of breast tissue. This makes sure that more carcinomas located in the axillary tail of breast tissue are detected. It is planned that MLO-positioning will be required as European quality standard for mammography. Our investigations show, however, that the MLO-projection has a number of distinct disadvantages that need to be discussed. Only 7 % of women at the most have an axillary tail demanding MLO positioning. Precise localization of a tumor is not possible anywhere in the breast if an MLO-projection is used. MLO positioning furthermore causes faese positives, so-called pseudolesions that demand further work-up. Radiotherapy is difficult because the tumorbed cannot be localized and thus precise saturation is not possible.