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Centers for Breast Health

Needle Localization

What is a needle/wire localization?

A needle/wire localization is a procedure used to help your surgeon find the area in your breast that needs to be removed. It is used when a mammogram or ultrasound has identified a small area of concern that cannot be felt. Before you go to surgery, the Radiologist will place a small needle/ wire next to the area of concern using imaging (e.g., x-ray, ultrasound) to enable your surgeon to accurately remove the area of concern while removing the least amount of normal breast tissue.

Where is the procedure performed?

The localization is performed the morning of your breast surgery. You will arrive at the Center for Breast Health. After arrival to the center, you will meet with the radiologist and assistants who perform the procedure. After signing a consent form, you may be given medication that your doctor may have prescribed for you.

What happens during the procedure?

There are three types of equipment and techniques that can be used to help guide placement of the wire in the breast. They are mammogram, ultrasound, or stereotactic-guided wire placement. The radiologist and the surgeon decide which procedure is easiest and best suited for you on the day of surgery, and it will be explained to you at the time of the procedure. After the radiologist and assistant see the area with imaging, a small needle is placed in your breast. A thin wire is passed through the needle and more pictures are taken to assure it is positioned near the area of concern. Occasionally more than one needle/wire will be placed to mark the area for the surgeon. In most cases you will only feel pressure, and possibly a pinch as the wire is placed. It will be very important that you remain still during the procedure.

Mammogram Needle Localization Procedure

This technique is very similar to the mammogram procedure. Most of the time, you will be seated in a chair and your breast will be placed into compression surfaces of the machine just like when you have a mammogram. Several X-rays will be taken from different views to determine the location of the abnormality. The needle and wire are placed as described above.

Stereotactic Needle Localization Procedure

Sometimes the stereotactic digital x-ray guidance is used. This procedure requires you to be positioned lying flat on your stomach with your breast hanging through a hole in the table. Frequently the stereotactic approach is used if a prior stereotactic biopsy has been performed and a clip marker was left in place. With the exception of positioning, much of the procedure is the same as the localization by mammographic x-rays.

Ultrasound Needle Localization

Occasionally a breast lesion/abnormality can only be seen on ultrasound, which uses sound waves to take pictures of the breast. You will be lying on your back and a wand-like instrument slides over your breast while pictures are seen on a computer. As with the other needle localization procedures, a small needle is inserted into the breast; followed by a placement of the wire.

What happens afterwards?

After the procedure, you will have tape and a dressing covering the wire, although you will not be able to feel the wire or have any discomfort. You will be dressed in a hospital gown and escorted back to the pre-operative area for surgery. You will be advised not to use your arms much until after surgery, to avoid movement of the wire.