Patients presenting for mammography are different ages and sizes and have varying body habitus; they include men, those who arrive on a stretcher or in a wheelchair, and those with very small breasts, large or wide breasts, pectus excavatum or pectus carinatum, a barrel chest, or kyphosis. The true professional must know how to image patients who deviate from the norm. In addition to competent positioning skills and anatomical knowledge, the mammographer needs a thorough knowledge of the various projections and the skills to modify any projection to meet the needs of individual patients.