What Is Breast Biopsy With Needle Localization?

The breast needle localization is performed in the following conditions:

• Impalpable lesions visualized in either sonography or mammography
• Cancerous lesion
• Palpable lesions that appear to be vague or uncertain in clinical finding
• Hard to perform a core biopsy
• Lesions that require complete excision
• A person unable to undergo core biopsy

The advantages of breast needle localization include:

• Decreased incidence and severity of vasovagal syncope (sudden drop in heart rate and blood pressure)
• It doesn’t increase the anxiety level as the procedure takes place below the table
• Short procedure time
• Low-cost procedure
• Ease of performing the procedure
• Greater patient satisfaction

The disadvantages of breast needle localization include:

• Difficulty in approaching lesions close to the chest wall
• Difficulty in locating small lesion in the large breast due to a small field of view
• Detecting small lesions requires magnification imaging

You have to inform the physician about your medical and medication history. The physician may ask you to stop certain medications for 3 to 5 days before the surgery, such as:

• Aspirin
• Blood thinners
• Herbal supplements

Do not wear any jewelry on the day of the procedure. Do not use deodorants or perfumes on the day of the procedure. Ask someone to accompany you for the procedure.

The physician identifies the abnormal area using a mammogram and ultrasound. Once the suspicious area is located, the physician places a marker on the breast. The physician numbs the breast area and then inserts a needle. A mammogram is taken to check if the needle arrives at the lesion. If the needle is not in the position, the physician will reposition it and repeat the imaging process. After positioning the tip of the needle, the physician injects a small amount of blue dye through it. Finally, the physician will either remove the needle or replace it with a wire and take to the surgery. The procedure takes about 60 minutes.

In another (newer) localization method, localizing devices, such as tiny pellets that emit small amounts of radiation (radioactive or magnetic seeds) or radiofrequency reflectors, which are small devices that give off signals, are placed under the breast. The surgeon detects the abnormal area by using a handheld detector because these devices emit signals.

The complications of breast needle localization include:

• Potential inaccuracies
• Dislodging or migration of wires before the surgery
• Pneumothorax (collapsed lung)
• Bruising
• Bleeding
• Infection