Wire-Guided Localization Biopsy for Non-Palpable Suspicious Breast Lesions

Abstract

Background: About 25% - 35% of breast cancers are non-palpable at the time of diagnosis. Wire guided localization (WGL) had been considered as the standard technique for many years for excision of theses breast lesions. The aim of this study is to assess the efficacy of WGL biopsy in the management of non-palpable suspicious breast masses. Patients & Methods: This retrospective study concerned thirty female patients who were presented by non-palpable breast lesions as proved by mammography and complimentary ultrasonography between February 2013 and September 2014. According to BIRADS classification system, all the lesions were BIRADS III, IV and V. However, BIRADS I and II lesions and lesions proved to be benign were excluded from this study. The patients were submitted to WGL under local anesthesia. Then, they were shifted to the operating theatre, where they underwent WGL biopsy. The removed specimens were sent for radiological confirmation of complete excision. Then, it was sent for histopathological examination. Results: The mean age was 52.63 years. Eighteen patients (60%) were asymptomatic, 7 (23.3%) patients were with breast pain, and 5 patients (16.7%) had nipple discharge. Ten lesions (33.3%) were BIRADS III, 17 lesions (56.7%) were BIRADS IV, and 3 lesions (10%) were BIRADS V. The WGL was done by mammography in 19 patients (63.3%) and under ultrasonographic guidance in 11 patients (36.7%). No post-operative complications were reported. The mean tumor size was 11.23 mm and the mean safety margin of excision was 6.7 mm. IDC was found in 56.7% or cases, DCIS in 30%, and ILC in 13.3% of cases. 40% of the lesions were of grade I, 30% were of grade II, and 30% were of grade III. There were positive resection margins in 11 patients (36.7%). Conclusion: WGL biopsy is a safe and reliable surgical technique for management of non-palpable suspicious breast lesions. Special care should be paid for proper margin excision. However, WGL biopsy is technically demanding and needs learning curve for both the surgeon and the radiologist.