Lange Mammography Practice Exam

On the MLO projection, the inframammary fold should be open to visualize the full thickness of the breast, especially the inferior and lateral portions and the tail of Spence. An open IMF means there’s no folding or crease along the inferior edge that would obscure tissue or cause overlap on the image. This positioning ensures that the breast tissue near the chest wall and along the inframammary boundary is captured clearly, improving detection of lesions and reducing distortion from tissue overlap. Achieving an open IMF involves proper positioning and compression so the breast lies smoothly against the receptor, with the fold not folded over itself. When the IMF is closed or creased, tissue on the inferior margin can be hidden or overlapped, compromising image quality. Therefore, the best practice is to have the IMF open on the MLO view.