LOCALIZATION OF IMPALPABLE BREAST-LESIONS - A SURGICAL APPROACH

The conventional approach to localization of impalpable breast lesions , i,e. employing a hooked mire with either stereotaxis or a perforated plate, has potential disadvantages for the operating surgeon, Often t he entry point of the wire lies some distance from the site of project ion of the lesion on the skin, The guide-wire should pierce the skin a t, or close to, the site of any proposed surgical incision and proceed along the shortest and most direct course towards the lesion. Ideally , the wire should lie within a radial distance of between 1 and 2 cm f rom its target, A method is described which achieves these objectives and involves both radiological and clinical measurements. A total of 6 65 guide-wire localized biopsies have been carried out at the above in stitutions between 1 November 1987 and 31 March 1995 and between 1 Jan uary 1994 and 31 March 1996. In only 4% of cases was re-positioning of the wire required. Excision of the radiological lesion mas obtained w ith a single biopsy in 99% of cases. A second or third biopsy was indi cated in 0.7% and 0.3% of cases, respectively, Migration of the wire o ccurred in two patients and no cases of wire transection or pneumothor ax were reported, This method of localization facilitates subsequent e xcision and permits the most appropriate incision consistent with opti mal cosmesis.