Subscribe to RSS
Wired for Surgical Success: Our Experience with Preoperative Ultrasound-Guided Wire Localization of Impalpable Breast Lesions
Aims The purpose of this study was to review our experience with preoperative ultrasound-guided wire localization and to identify our rate of successful localization and subsequent excision.
Materials and Methods At our institution, we performed preoperative wire localization for 28 impalpable breast lesions in 27 women (1 patient underwent wire localization for bilateral breast lesions), between April 2016 and August 2019. We used a Toshiba APLIO2 ultrasound machine and a linear probe (7–12 MHz) to visualize lesions and needle-wire systems comprising a 20-gauge needle with preloaded wire to localize lesions. We analyzed the percentage of specimen mammograms with wire in situ and percentage of excised specimens showing margins free of tumor, along with imaging features, BI-RADS (Breast Imaging-Reporting and Data System) categories, and histopathological and molecular diagnosis of the lesions.
Results All specimen mammograms confirmed the presence of wire in situ, except one (96.4%); in the latter case, postponement of surgery due to intractable cough was suspected to have caused wire displacement. All malignant specimens showed margins free of tumor (100%).
Conclusions Our results show that wire localization is extremely effective in providing crucial preoperative insight into the precise location of an impalpable lesion. Despite the advent of nonwire localization devices such as radioactive seeds, radar reflectors, magnetic seed markers, and radiofrequency identification tags, wire localization remains the most widely practiced method, especially in resource-limited settings. Its high degree of accuracy serves as a key factor in the successful outcome of breast conservation surgery for impalpable breast lesions.
01 June 2021 (online)
© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India
- 1 Hall FM, Kopans DB, Sadowsky NL, Homer MJ. Development of wire localization for occult breast lesions: Boston remembrances. Radiology 2013; 268 (03) 622-627
- 2 Kapoor MM, Patel MM, Scoggins ME. The wire and beyond: recent advances in breast imaging preoperative needle localization. Radiographics 2019; 39 (07) 1886-1906
- 3 Hall FM, Frank HA. Preoperative localization of nonpalpable breast lesions. AJR Am J Roentgenol 1979; 132 (01) 101-105
- 4 Kopans DB, Swann CA. Preoperative imaging-guided needle placement and localization of clinically occult breast lesions. AJR Am J Roentgenol 1989; 152 (01) 1-9
- 5 Mucci B, Shaw R, Lauder J, Pickard R. Localization of impalpable breast lesions: what are we aiming at?. Breast 2009; 18 (04) 267-269
- 6 Yuan Z, Qu X, Zhang ZT, Jiang WG. Application of localization and needle placement guided by mammographic, ultrasound and fiberoptic ductoscopy for resection of non-palpable breast lesions. Anticancer Res 2017; 37 (08) 4523-4527
- 7 Jakimovska Dimitrovska M, Mitreska N, Lazareska M, Stojovska Jovanovska E, Dodevski A, Stojkoski A. Hook wire localization procedure and early detection of breast cancer-our experience. Open Access Maced J Med Sci 2015; 3: 273-277
- 8 Das K, Sarkar DK, Karim R, Manna AK. Preoperative ultrasound guided needle localisation for non-palpable breast lesions. Indian J Surg 2010; 72 (02) 117-123
- 9 Shetty MK. Presurgical localization of breast abnormalities: an overview and analysis of 202 cases. Indian J Surg Oncol 2010; 1 (04) 278-283
- 10 Dua SM, Gray RJ, Keshtgar M. Strategies for localisation of impalpable breast lesions. Breast 2011; 20 (03) 246-253
- 11 Liberman L, Kaplan J, Van Zee KJ. et al. Bracketing wires for preoperative breast needle localization. AJR Am J Roentgenol 2001; 177 (03) 565-572
- 12 Goudreau SH, Joseph JP, Seiler SJ. Preoperative radioactive seed localization for nonpalpable breast lesions: technique, pitfalls, and solutions. Radiographics 2015; 35 (05) 1319-1334
- 13 Mango VL, Wynn RT, Feldman S. et al. Beyond wires and seeds: reflector-guided breast lesion localization and excision. Radiology 2017; 284 (02) 365-371