The breast needle localization helps to identify the exact location of a breast mass that is otherwise missed by touch
The breast needle localization helps to identify the exact location of a breast mass that is otherwise missed by touch

The breast needle localization helps to identify the exact location of a breast mass that is otherwise missed by touch (impalpable) for biopsy. Usually, a dye or small wire is placed at the point of the abnormality. After a needle biopsy, the physician recommends further diagnosis (biopsy) or surgery of the nonpalpable tissue. If the diagnosis reveals cancerous cells, the physician may recommend surgery.

When is breast needle localization indicated?

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

What are the advantages and disadvantages of breast needle localization?

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

How do I prepare for breast needle localization?

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:

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.

What can I expect during breast needle localization?

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.

What are the complications of breast needle localization?

The complications of breast needle localization include:

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

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Medically Reviewed on 10/21/2020
References
https://www.cedars-sinai.org/programs/imaging-center/exams/women/breast-needle-localization.html#:~:text=What%20is%20Breast%20Needle%20Localization,the%20point%20of%20the%20abnormality.

https://www.ajronline.org/doi/full/10.2214/ajr.174.6.1741689

https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/breast-biopsy/surgical-breast-biopsy.html

https://www.radiologyinfo.org/en/info.cfm?pg=breastbius