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Needle localization by X-Ray

Also known as

Stereotactic-guided core-needle biopsy, Breast needle localization x-ray, X-ray-guided needle localization, Wire localization biopsy.

This procedure is employed to help identify the accurate location of abnormal breast tissue for a later biopsy exam. The unhealthy point is marked usually with a small point wire or a dye. Breast Needle localization X-Ray is a procedure done prior to a breast biopsy or breast surgery to locate a breast abnormality seen on a radiograph but is not felt. It is also usually used to verify the location of an already diagnosed breast cancer. The exam is conducted under local anesthesia; hence there is no pain observed during the procedure. Other than some pressure, there is no significant pain or discomfort. A radiologist performs this Breast Needle Localization procedure. The results will be released to you after 2-3 business days. Wear fitting support clothing to care for your biopsy site and your comfort. Your radiologist will discuss with you if you need to wear any particular underwear type after your biopsy. Following the few days after the biopsy, you are advised not to lift anything heavier than 5 pounds or do any strenuous exercises. Do not bathe, swim or expose the biopsy site to water. However, you may shower 24 hours after the biopsy.
After a sample is taken for the biopsy, some breast lesions may require diagnostic or therapeutic biopsy. If a malignant or indefinite result is obtained, surgical excision is indicated. For this surgical session, accurate localization of the abnormal tissues is required for the complete removal of lesions and to minimize any unnecessary cosmetic disfigurement. Needle localization is the most routine procedure to help identify the accurate location of the abnormality in breast tissue. However, it is used for other parts of the body.
Your doctor will ask you to get the test in the following situations:
  • To locate and eventually remove any abnormal tissue or tumor visible on radiological exams.
  • Removing tissue from an obscured area too time-consuming or inefficient to locate for a surgeon.
  • To locate and eventually remove tissue samples for multiple abnormalities appearing on radiological exams.
  • To reduce the risk of recurrence by providing the surgeon with clear margins to excise healthy tissue along with the abnormal mass.
  • Consult your technician a few days before the procedure, if you wear on-body devices such as insulin pumps/ drug delivery pumps they cant be allowed in the X-ray room
  • Observe a fast from the midnight of the night before the procedure
  • The patient must not use any perfumes, deodorant, or talcum powder prior to the procedure.
  • You will be requested to change into a patient gown for your radiological exam.
  • You cannot wear any jewelry and are advised to leave accessories and valuables at home.
  • You are encouraged to bring some magazines or a book to help pass the time and relieve any anxiety about the procedure.
  • A nurse or a physician will explain the process to you and answer any questions you might have before signing a consent form.
A radiologist will do an X-ray to precisely locate the area of unhealthy tissue, and a needle will be placed in that area. Meticulous images would be taken to ensure clarity and needle location. A small wire will then be inserted and hooked in the tissue that needs to be removed; the needle will be removed. The wire will be removed during surgery. Firstly, the breast is cleaned with an antiseptic solution. Local anesthesia is introduced to numb the area to be examined for minimized discomfort. In some cases, when the patient is too anxious or uncooperative, a sedating agent may be injected through the veins. A technologist will first take preliminary films of the area while lying on a table or in an upright position to find the exact location of tissue abnormality. The procedure takes about 60 minutes to conclude.
A radiologist places a thin needle in the affected tissue with the help of radiographic images. Most people that undergo the procedure usually only experience mild pressure with needle insertion. The radiograph is then repeated multiple times to check and confirm the precise location of the needle. If the needle is not at the mass of abnormality, it will be repositioned and the imaging process repeated. Once the needle is positioned accurately, it is removed, leaving behind a wire hooked to the lesion in the breast. The wire is taped securely to avoid dislodgement during transportation and otherwise. The patient is taken to an operating room with the tape securing the wire. The surgeon makes an incision at the guidewire site and excises the wire and the lesion. Any swelling or bruising you may observe after the procedure will go to normal after a few days. However, a slight lumpiness at the surgical site from the scar tissue will be felt.
The sample obtained during the procedure will be examined by a pathologist (a doctor specializing in the causes and nature of disease). A final diagnosis will be made. The pathology report shows the nature of the specimen obtained, whether the tissue is benign or cancerous. They will share the results with your surgeon. Suppose the report concludes that the growth is cancerous. In that case, you may need additional tests to study the tumor type (growth, type of cells, and metastasis and characteristics). Afterward, your doctor will decide on further tests and procedures required. Do not hesitate to call your healthcare provider if:
  • you notice an increase in size in your breast
  • increased breast sensitivity and tenderness
  • there is bleeding that you are worried about