Improved accuracy of wire-guided breast surgery with supplementary ultrasound

Impalpable breast lesions have always been a challenge for breast surgeons. Stereotactic wire placement is frequently employed for lesion localisation. To improve the accuracy of preoperative localisation in these cases we introduced a supplementary ultrasound scan to identify the exact location of the wire tip. We studied two groups of 15 patients, from periods before and after the introduction of the new technique. Specimen mammograms from each case were examined to determine the proximity of the lesion to the centre of the specimen. The excision of the lesion was graded into excellent, accurate, satisfactory and inaccurate depending on the location of centre of the lesion with respect to the centre of the excised specimen. Our study shows an increase in the accuracy of localisation of screen detected breast lesions, following the introduction of the supplementary ultrasound scan. Furthermore, there is evidence of a benefit in terms of ease of surgery and reduced operation time. Theoretically the technique should also improve clearance margins and reduce the need for further surgery in therapeutic operations.