Related Experiment Videos
Localization of impalpable breast lesions--a surgical approach
G Q della Rovere1, J R Benson, M Morgan
1The Royal Marsden Hospital, Sutton, UK.
Abstract:
The conventional approach to localization of impalpable breast lesions, i.e. employing a hooked wire with either stereotaxis or a perforated plate, has potential disadvantages for the operating surgeon. Often the entry point of the wire lies some distance from the site of projection of the lesion on the skin. The guide-wire should pierce the skin at, or close to, the site of any proposed surgical incision and proceed along the shortest and most direct course towards the lesion. Ideally, the wire should lie within a radial distance of between 1 and 2 cm from its target. A method is described which achieves these objectives and involves both radiological and clinical measurements. A total of 665 guide-wire localized biopsies have been carried out at the above institutions between 1 November 1987 and 31 March 1995 and between 1 January 1994 and 31 March 1996. In only 4% of cases was re-positioning of the wire required. Excision of the radiological lesion was obtained with a single biopsy in 99% of cases. A second or third biopsy was indicated in 0.7% and 0.3% of cases, respectively. Migration of the wire occurred in two patients and no cases of wire transection or pneumothorax were reported. This method of localization facilitates subsequent excision and permits the most appropriate incision consistent with optimal cosmesis.
Insights
A new guide-wire localization method improves breast lesion biopsy accuracy. This technique minimizes wire repositioning, ensuring precise targeting for surgeons and better cosmetic outcomes.
Area of Science:
- Radiology
- Surgical Oncology
- Breast Imaging
Background:
- Conventional hooked wire localization for impalpable breast lesions has drawbacks.
- Wire entry point often distant from lesion projection, complicating surgery.
Purpose of the Study:
- To describe a novel guide-wire localization method.
- To improve precision, minimize surgical incision distance, and enhance cosmesis.
Main Methods:
- Combines radiological and clinical measurements for precise guide-wire placement.
- Evaluated in 665 guide-wire localized biopsies between 1987 and 1996.
Main Results:
- Only 4% of cases required wire repositioning.
- 99% of lesions excised with a single biopsy.
- High success rate with minimal complications like migration (0.3%), no transection or pneumothorax.
Conclusions:
- This method facilitates accurate lesion excision with optimal incision placement.
- Improves surgical efficiency and patient cosmetic results for impalpable breast lesions.