Breast lesion localization (mnemonic)

Last revised by Francis Deng on 28 Mar 2019

A mnemonic to help remember breast lesion localization when given a set of mammograms in mediolateral oblique (MLO) and 90-degree/true lateral (mediolateral [ML] or lateromedial [LM]) views to predict laterality is:

  • muffins rise and lead falls

This can help localize a finding on MLO during diagnostic mammography into the quadrant (e.g. upper outer), even when the finding is not well-seen on the craniocaudal (CC) view, in order to make ultrasound correlation easier.

Mnemonic

  • muffins rise: if the lesion appears in a higher position on the lateral than MLO, then it is located medially
  • lead falls: if the lesion appears in a lower position on the lateral than MLO, then it is located laterally

To remember the order of the views, remember that true lateral views are usually obtained in a diagnostic mammogram after an abnormality is initially found on a screening mammogram, which consists of an MLO and CC view.

For example, a lesion in the right breast at 2 o'clock will project around the level of the nipple on MLO and then appear to rise on the lateral view, as it is medial in the breast. A lesion in the right breast at 8 o'clock will project around the level of the nipple on MLO and then appear to fall on the lateral view, as it is lateral in the breast.

See also

  • triangulation, the physical implementation of this mnemonic using films on a viewbox to localize lesions

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