What is breast biopsy with needle localization?

Updated: Dec 28, 2015
  • Author: William Teh, MBChB, FRCR; more...
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As breast cancer screening with mammography increases, many impalpable breast lesions are being detected. These lesions should first and foremost be definitively diagnosed by using image-guided needle biopsy. After needle biopsy, some of these lesions may require diagnostic or therapeutic surgical biopsy. If a malignant or indefinite diagnosis is obtained, surgical excision is indicated. This, in turn, requires accurate localization of the lesion, which is required to ensure correct and adequate removal of the lesions and to minimize the degree of cosmetic disfigurement. [1]

The following images depict the localization of masses on mammograms.

Mammogram shows a spiculated mass to be transfixed Mammogram shows a spiculated mass to be transfixed by the guidewire.
Orthogonal (mediolateral) projection confirms the Orthogonal (mediolateral) projection confirms the position of the needle to be placed beyond the cluster of microcalcification.

See Breast Lumps in Young Women: Diagnostic Approaches, a Critical Images slideshow, to help manage palpable breast lumps in young women.

See Breast Cancer Evaluation, Ultrasonography in Breast Cancer, Mammography in Breast Cancer, and Magnetic Resonance Mammography for more information on these topics.

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