[Localization of non-palpable lesions of the breast using a metallic guide. Potential complications]

The authors reviewed the complications occurred in 393 patients who underwent needle localization breast biopsy from September, 1987, through September 1994. The lesions were located using 20-22 G needles with a teminal hook wire. The maneuver was carried out under US guidance in 7 patients, using stereotaxic equipment in 88 patients and without stereotaxic equipment in 298 patients. Clinical and guide-wire related complications were reported. The former complications were: severe vagal crises (in 3 patients), mild vagal crisis (10 patients) and bleeding (1 patient). Guidewire complications were: wire breakage (in 8 patients) and wire dislodgment (3 patients). Vagal crisis occurred above all in anxious patients. Guide-wire breakage or dislodgement may prevent lesion removal and, subsequently, lead to a diagnostic error. Our experiences suggests that information and continuous radiologist attendance positively influence patient's psychology reducing clinical complications. Moreover, operator's experience and care in choosing the appropriate devices greatly reduce the incidence of maneuver-related complications.