Needle localization of occult breast lesions

Excision of mammographically demonstrated breast lesions that are clinically occult remains a surgical challenge. Eighteen lesions were preoperatively localized (all but 1 with the Frank hooked wire technique). Eleven lesions were evaluated with specimen radiography. Three lesions proved to be malignant at biopsy and 15 were benign. We found hooked wire needle placement to be extremely accurate, enabling rapid excision of the suspicious mass with excision of rather small areas of the breast with no significant cosmetic defect. Mean anesthetic time for breast biopsy alone was slightly less than time for biopsy with needle localization, which was less than that when specimen radiography was employed. In the absence of a discrete lesion, specimen radiography is a useful adjunct. Needle localization is simple, accurate, rapid, and requires no special apparatus. Its widespread use should lead to the identification of more breast carcinomas in a potentially curable state.