Needle Localization

What is needle localization?
If needle localization using mammography is chosen
If needle localization using ultrasound is chosen
How to prepare for needle localization

What is needle localization?

Needle localization is performed by a radiologist immediately prior to surgical breast biopsy. Needle localization is used to increase the accuracy of the surgical biopsy when a tumor (lesion) is too small to be felt. Using mammography and/or ultrasound, the radiologist guides a wire marker next to the suspicious area so that the lesion may be accurately removed during surgery.

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If needle localization using mammography is chosen

If needle localization using mammography is chosen, you are seated in the same position as for mammogram. Using a compression plate with an opening, images are obtained. After these are reviewed, the skin is anesthetized with a freezing aerosol mist or Xylocaine. When the skin is numb, a hollow needle with a hooked wire inside is advanced toward the location of the lesion. Patients may experience some minor discomfort. X-rays are taken (again) in two positions to determine the proximity of the needle tip to the suspicious area. Occasionally, one or more adjustments to the needle are needed. When the position of the needle is judged appropriate, the wire is secured in place and the needle is removed. Once the localization is complete, you can be driven or escorted by a supportive partner to the hospital for surgical biopsy.

Needle localization procedures performed under mammography may require multiple x-ray exposures to ensure accurate placement of the needle. Please be assured that the latest x-ray equipment is used with high-speed film. The total radiation exposure is minimal. Patients are encouraged to express any concerns or questions with the radiologist or technologist at any time during the procedure.

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If needle localization using ultrasound is chosen

If needle localization using ultrasound is chosen, you are helped to lie down on a scanning bed with your arm(s) above your head. The radiologist locates the lesion using an ultrasound probe. Once the lesion is in view, the breast is numbed with a local anesthetic (usually Lidocaine or Xylocaine) and a hollow needle with a hooked wire inside is advanced toward the location of the lesion. Some patients experience some minor discomfort. When the position of the needle is judged appropriate, the wire is secured in place and the needle is removed. Two mammographic x-ray views are then taken to serve as a guide for the surgeon. Once the localization is complete, you can be driven or escorted by a supportive partner to the hospital for surgical biopsy.

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How to prepare for needle localization

Do not eat or drink or take anything by mouth from midnight before your needle localization. An empty stomach is required for the surgical procedure, which will follow the needle localization procedure.

Patients taking aspirin or aspirin related products
It is advised to stop taking aspirin or aspirin related (ibuprofen) products such as, Motrin, Advil or Aleve for at least seven days before this procedure to avoid excessive bleeding. Tylenol (acetominefin) is an acceptable substitute.

Patients taking Coumadin (anti-coagulants, blood thinners)
Consult with physician before scheduling this procedure. It is generally advised to stop taking Coumadin (anti-coagulants, blood thinners) for three to five days before this procedure to avoid excessive bleeding.

To avoid delay or rescheduling of your needle localization or surgical biopsy, arrive 15 minutes before your scheduled appointment time to register. Allow for one hour to one and a half hours to complete the procedure. Needle localization and breast surgery are performed in separate departments or locations. Make arrangements for a supportive partner to accompany you after the needle location procedure to the hospital or surgery center for your biopsy. Hospital staff may escort you in some locations.

Please do not wear any powder, perfumes, deodorant and/or lotions on your underarms and breasts to the needle localization procedure. Wear a loose-fitting bra, preferably without an underwire.

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