Wire Localization Procedure for Breast Biopsy or Lumpectomy

Patient waiting on examination table
How can wire localization help doctors find an abnormality seen on mammogram during surgery?. PhotoAlto/Michele Constantini / Getty Images

If your doctor has recommended a wire localization for an abnormality seen on mammogram or ultrasound, you're likely feeling nervous. How does this work? Are there any risks? Is it painful?


The use of wire localization for abnormalities found in the breast on mammogram or ultrasound has been around since the 1970s. This technique allows physicians to take a smaller sample of tissue at the precise location of an abnormality rather than surgically remove a large piece of tissue hoping that it contains the abnormal region.

The technique is very successful in locating abnormal regions with a success rate of 95 to 100 percent.

What to Expect During Your Procedure

Wire localization is a technique that is used to mark the location of a breast abnormality that is quite small, or that can't be easily found by touch. This procedure ensures greater accuracy for a breast biopsy or lumpectomy. Your surgeon will use the wire as a guide to the tissue that needs to be removed.

Getting The Right Picture at the Right Place

Your wire localization will be done in the Radiology Department of the hospital or surgical center where your breast biopsy or lumpectomy is scheduled. Mammograms (or a breast ultrasound) must be done first to show the location of your breast abnormality. You will need to remove your gown from your affected breast and get into position for a mammogram or ultrasound. Special equipment, such as a paddle-shaped compression device may be used during your mammogram.

It may be necessary to take several images in order to find the exact location of your lump, calcifications, or area of concern.

Preventing Breast Pain

You will be awake during the placement of the wire, but your breast will be numbed so that you won't feel pain from the needle or the wire. Your radiologist will inject a local anesthetic, to numb your breast before the wire placement.

You may feel a small sting from the anesthetic needle, but as the anesthesia takes over, you should not notice any other pain. It is possible to feel pressure or pulling sensations during the wire placement, and some women said that they felt faint or dizzy during the procedure. If you feel anything that is uncomfortable, let your radiologist know right away, so they can help you.

Inserting the Wire

Now that images have been taken, and your breast has been numbed, your radiologist will use a very fine needle (smaller than is used for a blood draw) to target your breast abnormality. The tip of this needle must rest in the location that your surgeon needs to find, in order to remove the right tissue. A slender wire will be threaded down through the needle and out of its tip, to lodge at the target tissue. The needle will be removed, leaving the wire in place.

Double-Checking the Wire Location

With the wire in place, you will have another mammogram, to check that the tip of the wire is properly positioned. If the wire is not in the correct place, your radiologist will reposition and re-check it, to ensure accurate placement. When the wire is finally positioned, it will be secured in place with tape or a bandage.

Timing of Your Wire Localization With Other Procedures

Your wire localization procedure can take about an hour and is usually scheduled two hours before your biopsy or lumpectomy. When the wire has been properly placed and secured in position, you will be ready for your next procedure. The wire will be removed, along with some breast tissue, during your surgery.

Possible Risks of Wire Localization

There are very few risks associated with wire localization, including the small risk of bleeding or infection at the site where the wire is introduced.

Some of the time a physician will be unable to properly direct the wire to the abnormal tissue in question, and other techniques will be needed.

After Your Procedure

The wire is left in place until your procedure is started and then removed along with the tissue it was used to mark.

Bottom Line on Wire Localization of Breast Abnormalities

When abnormalities are seen on a mammogram or ultrasound it can be very hard to determine exactly where these abnormalities lie in the operating room. Marking the abnormal tissue has been extremely helpful in reducing the amount of tissue removed during a breast biopsy or lumpectomy while ensuring that the abnormal tissue is clearly removed.

Since the adoption of wire localization, other procedures are being evaluated to mark abnormalities prior to surgery. The goal of these approaches is two-sided, with the hope that less invasive surgeries can be done while at the same time improving the rate that any abnormal findings on imaging tests are removed and evaluated fully.

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