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Wire Localization for Breast Surgery


Medical editor Marit Muri Holmen MD
Radiologist
Oslo University Hospital
Norway

General

Wire localization is performed prior to surgery for non-palpable lesions. A wire is inserted, usually with the help of ultrasound, with the point of the needle in or close to the lesion. If the lesion is not visible on ultrasound, the wire can be inserted using stereotactic or off-hand technique. After excision, the specimen is X-rayed to verify removal of the lesion.

Except for a small puncture in the skin from the needle, there is little discomfort associated with this procedure.

Indications

  • Non-palpable lesions to be removed surgically

  Goal

  • Localize and mark non-palpable lesions.

Equipment

  • Needle and guide wire with hook
  • Dedicated wire localization equipment 

Preparation

  • No preparations for the marking procedure
  • Local anesthesia is not required
  • Normal preoperative preparations for subsequent surgery

Implementation

  • The point of the needle is inserted through the lesion with the needle in or right behind the lesion.
  • The guide wire with hook is inserted into the breast tissue through the needle. 
  • Mammograms are taken after the marking to check the positioning of the wire.

There is little pain associated with the procedure, with the exception of the pinprick in the skin.


Follow-up

During surgery the surgical biopsy is X-rayed to check that the biopsy is representative.

Histological examination of the specimen

  • The specimen is fixed in formalin for 1 day before sectioning. The control X-ray accompanies the specimen. 
  • The specimen is examined and described macroscopically.
  • The specimen is cut into thin, parallel slices (maximum 5 mm). The slices are placed on a slide and are examined by X-ray if necessary.
  • The radiologist states in which slices the lesion is located.
  • Sections are prepared for histological examination from the relevant slices.

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