Objective: To analyze the value of ordinary mammography (MG) in distinguishing benign and malignant breast masses. Methods: This prospective study included 62 patients who visited the hospital from June 2022 to June 2024 due to breast nodules. All patients underwent MG and pathological examination after admission. Each patient received conventional MG and MG in a specific projection position. Pathological results were used as the gold standard to evaluate the efficacy of the two MG methods. Results: Pathological results showed 43 cases with malignant nodules and 19 cases with benign nodules. Conventional MG results showed 39 cases with malignant nodules and 23 cases with benign nodules. The results of MG in a specific projection position showed 43 cases with malignant nodules and 19 cases with benign nodules. Compared with pathological results, the sensitivity, specificity, accuracy, positive and negative predictive values of conventional MG were 62.8%, 36.8%, 54.8%, 69.2% and 30.4%, which of MG in a specific projection position were 81.4%, 57.9%, 74.2%, 81.4% and 57.9%. The accuracy of MG in a specific projection position was significantly higher than that of conventional MG (P<0.05). The rate of grade A images obtained from MG in a specific projection position was significantly higher than conventional MG (P<0.05). The unqualified rate was significantly lower than that of conventional MG (P<0.05). The rates of grade B images obtained by the two methods were comparable (P>0.05). Conclusion: MG in a special position is efficient in distinguishing benign and malignant breast masses, and can significantly improving image quality, thus providing a scientific and accurate image basis for clinical practice.