Needle Localization Procedures Offered in Baltimore

Mercy Breast Center

If your breast biopsy results indicate a cancerous or precancerous abnormality, surgery is usually recommended to totally remove that area of tissue.  If the abnormality is not palpable (cannot be felt on physical exam) it is often necessary to perform a needle localization procedure prior to surgery.

The radiologists at Mercy in Baltimore offer needle localization guided by mammography, ultrasound or MRI. Our radiologists work closely with our breast surgeons to provide complete and comprehensive treatment for breast cancers and abnormalities.

What is a Needle Localization procedure?

A needle localization procedure is usually recommended to aid in the removal of a cancerous or precancerous abnormality that is not palpable (cannot be felt in a physical exam). During a needle localization procedure a thin wire is temporarily placed into the breast to help guide the surgeon to the exact area of concern.

Following the needle localization procedure, the breast surgeon is able to follow the wire into the breast and remove the area of abnormality. On the day of surgery, before going to the operating room, the radiologist performs the needle localization procedure in the Women’s Imaging suite.  In some cases, the needle localization may be performed by the surgeon in the operating room.

Needle localization may also be performed if ultrasound-guided, stereotactic, or MRI-guided biopsies have been unsuccessful at obtaining a diagnosis or are technically unable to be performed. 

NEXT: What types of Needle Localization procedures are offered at Mercy? ›
What types of Needle Localization procedures are offered at Mercy?

Your radiologist and breast surgeon will work together to determine the best needle localization for your particular case. Needle localizations may be performed using:

  • Mammographic guidance
  • Ultrasound guidance
  • MRI guidance 
NEXT: What is a Mammography-guided Needle Localization? ›
What is a Mammography-guided Needle Localization?

Mammography-guided needle localization is performed by the radiologist using mammography to temporarily place a thin wire in the exact location of the abnormality. This helps guide the surgeon to remove the area of concern.

Typically, the patient is seated during this procedure and the breast is held in compression in the mammography machine. The compression paddle used for localization has an open area in the center, which allows passage of the needle. Mammogram images are obtained to visualize the area of concern and a grid is used to calculate the precise location of the abnormality. 

The skin is cleansed with an antiseptic solution and a small amount of local anesthetic is given to numb the area. A hollow needle is then placed in the breast and images are obtained to document accurate positioning of this needle. A small amount of temporary blue dye is injected into the breast tissue (this aids the surgeon in visualizing the area during the operation). A very thin wire is then placed through the needle and the needle is removed.  

Final mammogram images are taken to document wire position and these images are sent with the patient to the operating room for the breast surgeon. The wire causes no pain and is removed when surgery is performed later the same day.

NEXT: What is an Ultrasound-guided Needle Localization? ›
What is an Ultrasound-guided Needle Localization?

Ultrasound-guided needle localization is performed using ultrasound to temporarily place a thin wire in the exact location of the abnormality. This helps guide the surgeon to remove the area of concern.

During this procedure, the patient lies on her back on the ultrasound exam table. Ultrasound is used to locate the area of abnormality in the breast. The skin is cleansed with an antiseptic solution. Local anesthetic is injected into the skin and breast tissue to numb the area. 

Using ultrasound guidance, the doctor places a hollow needle into the breast, directing it to the area of abnormality. A small amount of temporary blue dye is injected into the breast tissue (this aids the surgeon in visualizing the area during the operation). A very thin wire is then placed through the needle and the needle is removed.  

Mammography images are taken to document positioning of the needle and both the ultrasound and mammogram images are sent with the patient to the operating room for the breast surgeon. The wire causes no pain and is removed when surgery is performed later the same day.

NEXT: What is an MRI-guided Needle Localization? ›
What is an MRI-guided Needle Localization?

MRI-guided needle localization is performed by a radiologist in the MRI suite. It is used to guide the surgeon to an area of abnormality which is visible only on MR (magnetic resonance) imaging, so that the area can be removed.

For this procedure the patient lies face down on the MR exam table with her breasts suspended below the table in a “breast coil,” which helps to hold the breast still. Preliminary MR imaging is performed after the patient receives an IV injection of a contrast agent and the radiologist reviews the images to locate and target the area of concern. A computer system calculates the exact location of the abnormality in three-dimensional space. 

The skin is cleansed with an antiseptic solution and local anesthetic is injected into the skin and breast tissue to numb the area. A hollow needle is placed into the breast and directed toward the area of abnormality.  MR images are obtained to document that the needle is in good position. A small amount of temporary blue dye is injected into the breast tissue (this aids the surgeon in visualizing the area during the operation).  A very thin wire is then placed through the needle and the needle is removed. The wire causes no pain and is removed when surgery is performed later the same day.