The Utilization of Wire-Guided Localization in the Management of Nonpalpable Breast Lumps at a Teaching Hospital in...

Breast cancer is the highest cause of female cancer deaths worldwide. Africa bears the brunt of this devastating disease mainly due to a lack of awareness and late presentation. Recently, a new cohort of patients in some jurisdictions in Africa have presented with small nonpalpable breast tumors due to early detection or following neoadjuvant chemotherapy.

This study documented the initial experience of wire-guided localization of nonpalpable breast tumors in a Ghanaian tertiary hospital, used to facilitate the achievement of negative surgical margins.

This was a retrospective evaluation and analysis of clinical, radiological, and histopathological data of 45 patients who had image-guided wire localization of nonpalpable lumps immediately prior to surgical excision at the Korle Bu Teaching Hospital over more than a 4-year period. The study evaluated the preprocedural radiological diagnosis, tumor size, histology, and completeness of resection.

Median age at presentation was 50 years. Clinical indications of these nonpalpable lesions included 13.3% post neoadjuvant chemotherapy and 40.0% of chemotherapy naive histologically diagnosed breast cancers. The median size of the excised lesions was 13 mm. Excision was associated with clear margins in most cases. Up to 53.3% of the lesions were malignant, out of which invasive ductal carcinoma NST was the commonest histology.

Ultrasound-guided wire localization has proven to be a beneficial tool in breast-conserving surgery in an LMIC environment. More than half the pathologies localized were malignant, with 96% showing clear margins.