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Surgical considerations in needle localization procedures.

Abstract

There is an increasing need for needle localization biopsies. Cancers so detected are usually at an earlier stage and should result in an increased cure rate. The surgeon involved in these procedures should, of necessity, be proficient in evaluating mammographic abnormalities, since there is considerable variation in the way they are reported by various radiologists. Localization can be accomplished with various hooked wires or dye, but accuracy of placement is more important than the method used and this point is well understood by cooperative radiologists. Since 70-80% of these lesions will be benign, cosmesis should be kept in mind. Incisions should be placed centrally, if possible, and the volume excised should be minimal and not lead to deformity. When poorly localized, excision of these lesions can be a trying experience for the experienced surgeon.

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BibTeXRIS

A J DePalo. Surgical considerations in needle localization procedures.. https://doi.org/10.1002/ssu.2980070504

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Targeting difficult accessible breast lesions: MRI-guided needle localization using a freehand technique in a 3.0 T closed bore magnet.

PURPOSE: To report the accuracy of magnetic resonance imaging (MRI)-guided needle localization for diagnosis of MRI detected suspicious breast lesions located in difficult accessible regions of the breast, using the freehand method in a 3.0 T closed bore magnet. MATERIALS AND METHODS: In five patients with five MRI-only breast lesions underwent MRI-guided needle localization for histopathologic evaluation of the lesions. All interventional procedures were performed in a 3.0 T MRI system with the patient in prone position and by using a dedicated phased array breast coil. MRI-guided needle localizations were performed by using a freehand technique. In our study, the high-resolution scan allowed preprocedural localization of all lesions without use of contrast enhancement. In all cases contrast-enhanced MRI was performed after insertion of the wire to confirm the tip of the wire in direct contact with the enhancing lesion. RESULTS: Needle localizations were performed in five patients. Histopathologic evaluation of tissue after surgery excision biopsy revealed one lymph node, three invasive ductal carcinoma and one ductal carcinoma in situ. Lesion size varied from 6 to 30 mm. Mean duration time was 25 min. No complications occurred during the intervention method. In the patient with the benign lesion control MRI of the breast after 6 months confirmed lesion removal. CONCLUSIONS: MRI-guided needle localization by using a freehand technique in a 3.0 T closed bore magnet is a safe and accurate method for diagnosis of difficult accessible breast lesions only visible on MRI.

Biopsy, Needle↗