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Sampling of Procedures

Breast needle localization procedures

A needle localization is a pre-surgical procedure performed in the Radiology Department. This procedure is performed for breast lesions that are too small to be felt by the surgeon but are found on the mammogram. The radiologist, with the assistance of a radiologic technologist specialized in mammography, will mark the area of the breast to be biopsied using a needle and wire. The wire will guide the surgeon to the area of the abnormality.

The advantages of performing needle localization are that the abnormality can be accurately marked for surgical removal and that a smaller amount of tissue can be removed than would be possible if no localization were performed

  • Core needle biopsy (CNB)
    This procedure uses a larger gauge, hollow needle that has a special cutting edge. The area of the breast containing the abnormal tissue is numbed with local anesthesia and the needle is inserted into the mass. If the mass is not palpable, the needle is guided by ultrasound or stereotactic imaging. Three to five small, cylindrical pieces of tissue are removed through multiple insertions of the needle. The insertion point is closed with a small bandage and stitches are not required.
  • Ultrasound
    Ultrasound uses high resolution sound waves to outline a part of the body. In this procedure, sound waves are transmitted through the breast tissue and echoes of the sound waves are picked up and translated by a computer into an image displayed on a computer screen. The physician uses the image displayed on the screen to guide the biopsy needle into the precise area to be studied.
  • Stereotactic needle biopsy
    This procedure uses computers to map the exact location of the mass or calcifications using mammograms taken from two angles. The computer then guides the placement of the needle in the appropriate spot.
  • Wire localization
    This procedure is used to locate breast masses to be removed by open surgical biopsy. A very thin, hollow needle is placed in the breast after the area is numbed with a local anesthetic. x-rays are taken to pinpoint the abnormal area and to guide placement of the needle. When the needle is positioned appropriately, a thin wire is inserted through the center of the needle. With the wire held in place by a small hook at the end, the needle is removed and the physician uses the wire to locate the abnormal area to be removed.
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