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Needle Localization

Needle localization uses mammography to help a radiologist insert a wire into an area of concern. This wire then directs the surgeon to the area to be removed or biopsied. This exam is similar to ultrasound wire localization. What determines whether the exam is done in mammography or ultrasound is simply how the area of concern is best visualized.

How do I prepare for needle localization?

Your surgeon will provide you with pre-surgical instructions. Do not apply any lotion, powder, or deodorant to your breast or underarm area the day of surgery.

What can I expect during ultrasound-guided needle localization?

Ultrasound uses high frequency sound waves to image internal structures of your breast.
  1. You will be positioned on your back or slightly turned to your side for the procedure. A nurse and ultrasonographer will assist the radiologist with the procedure.
  2. A cold, gel-like substance will be applied to your skin. The gel helps the sound waves travel through the breast for a better image of the breast tissue.
  3. The ultrasound probe, or transducer, is placed on the gel and moved over the breast to locate the area to be biopsied.
  4. When the area has been located, it will be cleansed with hospital soap (unless you are allergic to iodine). The doctor will inject local anesthetic into the breast. This anesthetic is similar to what is used in the dental office.
  5. A needle is inserted into the breast. The radiologist will guide the needle to the area by constantly tracking it on the monitor screen.
  6. Once the needle is placed, the location is marked by injecting blue dye into the tissue through the needle. This serves as a visual guide for the surgeon.
  7. A thin wire is inserted through the needle into the breast tissue.
  8. After the wire is in place, the needle is removed.
  9. A mammogram is done to check the final wire placement. These films will go with you to surgery.
  10. After the radiologist has verified the final mammogram, the wire will be covered and taped in place.

What can I expect during mammography-guided needle localization?

  1. You will be positioned either in a standing or sitting position. A nurse and mammography technologist will assist the radiologist with the procedure.
  2. The mammography technologist will place your breast in compression using a specially designed compression plate. The compression is less than when having a regular mammogram.
  3. An x-ray will be taken to locate the exact area to be biopsied.
  4. The area will be cleansed with hospital soap (unless allergic to iodine). The doctor will inject local anesthetic into the breast tissue before inserting the needle into the breast. This anesthetic is similar to what is used in the dental office.
  5. After the needle is placed two x-rays are taken to confirm the location of the needle. Sometimes the needle needs to be repositioned, as precision is vital.
  6. One the needle placement is verified, the location is marked by injecting blue dye into the tissue through the needle. This serves as a visual guide for the surgeon.
  7. A wire is inserted through the needle into the breast tissue.
  8. After the wire is in place, the needle is removed.
  9. A mammogram is done to check the final wire placement. The films will go with you to surgery.
  10. After the radiologist has verified the final mammogram, the wire will be covered and taped in place.

How will I find out the results?

Your surgeon will inform you of the pathology results. Any follow up instructions will be given to you by your physician and the hospital prior to being discharged. For more information or to schedule an appointment, call 832-912-3724.

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