Breast needle localization

Abnormal tissues may be difficult to find during surgery even when they show up clearly on your x-ray. When abnormal tissue is discovered, the most effective way to reduce your risk of cancer is to remove the tissue entirely.

In order for your surgeon to remove the area of breast tissue that contains the area of concern, he or she will need a guide to show the exact location of the abnormality. Needle localization is most often performed immediately prior to surgery on patients who are having surgical breast biopsies or lumpectomies. The breast localization procedure will result in precise pinpointing of the abnormality thereby increasing your surgeon’s ability to remove all of the abnormal tissue while reducing the removal of healthy tissue. It also reduces the length of time you are in surgery.

The needle localization may be performed under ultrasound guidance, mammographic guidance, or MRI guidance depending on which type of imaging best shows the abnormality. The most common way to perform needle localization is to use mammographic guidance.

The breast needle localization takes less than one hour. Most often, you will be asked to arrive at the hospital on the day of your biopsy surgery early enough to have the needle localization done prior to your surgery.

• The procedure will be done in the radiology department unless you are instructed otherwise.

• Be sure to follow instructions regarding eating and drinking prior to surgery.

• Before the procedure you will put on a hospital gown.

• During the procedure images of the breast will be obtained and abnormality identified.

• The radiologist will numb the area and then insert the localization needle toward the exact position of the abnormality.

• Another x-ray will be taken to confirm the location of the needle. Since your radiologist will want to pinpoint the exact location of the abnormality for your surgeon, the needle may need to be repositioned.

• When the radiologist has determined that the abnormality has been targeted, a very thin small guide wire will be inserted down through the inside of the needle to mark the position of the abnormality. A small hook at the end of the wire keeps it in place in the breast.

• The wire is taped to your skin.

• Two final films will be taken to show your surgeon the exact location of the wire and the localization procedure is complete.

• When the localization procedure is complete you will be escorted back to the operating room where the surgeon will remove the tissue.


Frequently asked questions

Is the procedure painful?

The radiologist will numb the skin and the deeper tissue within your breast with a small needle. The injection of anesthetic may sting for a few seconds. Once the anesthetic has taken effect, you should not feel any pain during the placement of the needle. You may feel the pressure of the compression paddles but it shouldn’t be any worse than with mammography. Once the localization procedure is complete patients rarely experience discomfort.

Who performs the needle localization procedure?

A board certified radiologist who is trained in reviewing mammograms and breast ultrasounds will perform the procedure. The radiologist will be assisted by a technologist who is also trained in this procedure.

What should I expect?

On the day of your breast needle localization, please do not wear any lotions, powders or deodorant around your breast or under arms.

• As in the mammogram, your breast will be placed between specially designed compression plates.

• Before the localization procedure, an x-ray will be taken from different views to determine the location of the abnormality.

• A needle will be inserted into your breast to mark the exact position of the abnormality.

• Once properly located, the needle will be removed leaving a thin wire as a guide for your surgeon.

• Once identified, the procedure for marking the area is the same as the procedure using mammographic guidance.

If you have any questions about the procedure, ask your radiologist or the technologist. Your complete understanding of this procedure is important.

Hallmark Health Needle Localization Facilities:

  • Lawrence Memorial Hospital

170 Governors Avenue, Medford, MA 02155

  • Melrose-Wakefield Hospital

585 Lebanon Street, Melrose, MA 02176

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