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The Challenging Image-Guided Preoperative Breast Localization: A Modality-Based Approach.

Mary S Guirguis1, Beatriz E Adrada1, Marion E Scoggins1

  • 1Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX 77030.

AJR. American Journal of Roentgenology
|October 6, 2021
PubMed
Summary

Accurate breast lesion localization is key for successful breast conservation surgery (BCS). This guide offers practical, modality-based techniques for challenging pre-operative localizations, improving surgical outcomes.

Keywords:
breast conservation surgerybreast surgeryimage-guided preoperative breast localizationnonwire localization devicewire localization

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Area of Science:

  • Radiology
  • Oncology
  • Surgical Oncology

Background:

  • Breast conservation surgery (BCS) is standard for early-stage and select locally advanced breast cancers.
  • Accurate localization of nonpalpable lesions by radiologists is crucial for successful BCS.
  • Challenging localizations require specialized techniques and careful planning.

Purpose of the Study:

  • To provide a practical, modality-based guide for approaching challenging pre-operative breast lesion localizations.
  • To highlight techniques for sonographic, mammographic, and MRI-guided localizations.
  • To discuss pre-procedure planning, modality selection, patient communication, and device considerations.

Main Methods:

  • Review of modality-based techniques for challenging pre-operative breast lesion localizations.
  • Inclusion of examples under sonographic, mammographic, MRI, and multi-modality guidance.
  • Consideration of clip and device migration and overview of localization devices used in the US.

Main Results:

  • Successful BCS relies on accurate pre-operative localization of breast lesions.
  • Modality-based techniques can be effectively applied to overcome localization challenges.
  • Comprehensive planning and technique selection are vital for optimal results.

Conclusions:

  • Challenging breast lesion localizations can be successfully managed with appropriate modality-based techniques.
  • Radiologists play a critical role in facilitating BCS through precise lesion localization.
  • Adoption of specific techniques enhances the success rate of breast conservation surgery.