What are the possible complications of breast biopsy with needle localization?

Updated: Dec 28, 2015
  • Author: William Teh, MBChB, FRCR; more...
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Answer

Answer

All localization methods are subject to potential inaccuracies. [14] It is important to confirm the correct placement of the guidewire. Ultrasonographic and mammographic wire localizations can be followed by mammography performed in 2 planes (eg, lateromedial and craniocaudal projections) to confirm that the correct lesion has been accurately targeted.

Ideally, the guidewire should transfix the lesion on both projections (see the image below). The tip of the guidewire should ideally be placed within 1 cm of the target lesion.

Mammogram shows a spiculated mass to be transfixed Mammogram shows a spiculated mass to be transfixed by the guidewire.

Guidewires may be dislodged or may migrate before surgery. Complications, including pneumothoraces, have been described. Wire fragments may also be retained following surgery. Published literature show that the rate of needle-localization failure is in the range of 0-20%. Factors associated with such failure include the following [17, 18, 19] :

  • Lesion type

  • Lesion size

  • Increased distance of the needle from the lesion

  • Decreased breast size

  • Decreased specimen volume


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