Needle Localization for Surgical Biopsy
Needle localization is performed by a radiologist immediately prior to surgical breast biopsy. Needle localization is used to increase the accuracy of the surgical biopsy when a lesion is too small to be felt. Using mammography and/or ultrasound, a radiologist guides a wire marker next to the targeted mass so that it may be accurately located during surgery.
- Mammography guided needle localization procedures. Patient is seated during this procedure, with the breast held in the mammogram machine. The compression paddle used for localization has an opening in the center to allow passage of the needle. A mammogram is taken in this position, which shows the precise location of the abnormality. The radiologist calculates the coordinates for needle placement, and the needle is advanced quickly into the breast. This may cause mild discomfort, much like having blood drawn.
Following the needle placement, additional mammograms are taken to confirm accurate placement and to demonstrate wire position. The wire is secured with tape and is removed along with the specimen during surgery. Most women are caused no discomfort by the wires.
- Ultrasound guided needle localization requires the patient to lie down on a scanning bed with her arm(s) above her head. The radiologist locates the lesion using an ultrasound probe. Once the lesion is in view, the breast is numbed with a local anesthetic and a hollow needle with a hooked wire inside is advanced toward the location of the lesion. Some patients experience some minor discomfort. When the position of the needle is judged appropriate, the wire is secured in place and the needle is removed. Two mammographic X-ray views are then taken to serve as a guide for the surgeon.