A certified technologist performs the exam according to standards set by the American College of Radiology. The breast is placed between two compression paddles. The breast needs to be compressed to allow better visualization and differentiation of abnormalities from normal tissue such as surrounding glandular elements, fat and ducts. The examination usually consists of four images, two views of each breast. Additional views may be needed to better delineate certain portions of breast tissue in an effort to visualize as much breast tissue as possible. Patients with implants require additional view to visualize around the implants.