Related Experiment Video
Updated: Jun 17, 2026
Clinical Imaging of Microwave Mammography
Published on: November 14, 2025
Mammogram geometric projection localization (MaGPL) for surgical body-surface localization of nonpalpable breast
Xiangqing Chen1,2, Xin Lin1,2, Bo Liang3
1Department of Breast Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Background:
Precise surgical excision of nonpalpable breast microcalcifications remains challenging when conventional localization equipment is limited or not routinely available across clinical settings, underscoring the need for an accessible and reproducible alternative approach. This study aimed to assess the feasibility and localization accuracy of a novel mammography-based localization strategy for guiding diagnostic surgical excision of nonpalpable breast microcalcifications.
Methods:
This multicenter retrospective study evaluated a mammography-based geometric localization approach termed mammogram geometric projection localization (MaGPL). The technique applies a boundary-defined, range-based "Maximal Width Crossing Criterion" to reconstruct a body-surface coordinated field from two standard mammographic projections, preferentially the craniocaudal (CC) and lateromedial (LM) views. By deliberately selecting the most geometrically stable boundary information from each projection, MaGPL defines axis-specific localization boundaries, forming the geometric basis for boundary-defined localization of nonpalpable calcifications. A total of 41 patients (45 lesions) underwent diagnostic excision guided by MaGPL. Localization accuracy was evaluated using the geometric offset (D offset ), defined as the linear distance between the radiographic center of the calcification cluster and the center of the excised specimen measured on intraoperative mammography.
Results:
The cohort had a median age of 48 years (range, 25-81 years) and a mean mammographically estimated breast volume of 370±158 mL. The mean linear extent of the target calcification clusters was 22.6±15.1 mm (range, 3.0-67.0 mm), and pathologic examination confirmed malignancy in 18 of 45 lesions (40.0%). All calcification clusters were successfully excised in a single operation, achieving a 100% intraoperative retrieval rate. The median D offset was 9.7 mm [interquartile range (IQR), 8.3-13.0 mm], indicating a clinically acceptable level of geometric localization precision. Orthogonal CC + LM projections yielded smaller offsets than non-orthogonal combinations (P=0.003). Larger breast volumes were associated with greater D offset (P<0.001), whereas breast density and calcification extent or location showed no significant association.
Conclusions:
MaGPL represents a standardized, equipment-independent alternative for body-surface localization to guide surgical excision of nonpalpable breast microcalcifications, offering reproducible and clinically applicable localization accuracy without additional cost, with particular utility in community and resource-limited settings.
