Usefulness of hook wire localization biopsy under imaging guidance for nonpalpable breast lesions detected radiologically

Masroor, Imrana; Afzal, Shaista; Shafqat, Gulnaz; Rehman, Hasan

doi:10.2147/ijwh.s35280

Cited by 14 publications

(17 citation statements)

References 14 publications

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“…It has been reported that the hook-wire positioning technique has multiple complications, particularly unhooking. Unhooking frequently occurs during patient transfer or during surgery, and may occur under the state of pulmonary collapse or during excision because the operator often strains the positioning steel wire when excising lumps (Tsushima et al, 2008;Masroor et al, 2012). In addition, partial reports have indicated that the cutting closer may cut off the steel wire during surgery (Rozen et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Zhai

Guan

et al. 2015

Genet. Mol. Res.

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ABSTRACT.This study aimed to analyze the clinical application value of computed tomography (CT)-guided hook-wire positioning before thoracoscopic surgery. Eighty-four patients who had received a thoracoscopic wedge resection of pulmonary nodules between January and December 2013 were selected. Group A consisted of 38 cases where the hook-wire positioning technique was not used, and the positioning approaches were intraoperative observation and palpation. Group B consisted of 46 cases where the hook-wire positioning technique was used. The diameter of each nodule was less than 2 cm, and all patients underwent the operation within 2 h of invasive positioning. The evaluation indexes included positioning success rate, positioningrelated complications, and rate of conversion to thoracotomy. In Group A, nine patients (23.68%) underwent conversion to thoracotomy; in Group B, three patients (6.52%) did. This difference was statistically significant (P < 0.05). The average operation duration was 118 ± 21 min in Group A and 53 ± 18 min in Group B. The difference between both groups was statistically significant (P < 0.05). The average length 3799 Positioning of pulmonary nodules ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 14 (2): 3798-3806 (2015) of hospital stay of patients who underwent conversion to thoracotomy was 8.7 ± 2.2 days, and of patients who underwent thoracoscopic pulmonary wedge resection was 4.5 ± 1.6 days. This difference was statistically significant (P < 0.05). Therefore, CT-guided hook-wire positioning of pulmonary nodules before thoracoscopic surgery has clinical application value. It helps to accurately locate the pulmonary nodules, effectively lowers the rate of conversion to thoracotomy, and reduces the operation duration.

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Section: Discussionmentioning

confidence: 99%

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Zhai

Guan

et al. 2015

Genet. Mol. Res.

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“…The fact that as high as 50-80% of biopsies of non-palpable lesions revealed benign results might raise the question that unnecessary biopsies have been performed (5,(24)(25)(26)(27)(28)35). Taking this situation into consideration, from a cosmetic point of view, the decision for surgical excisional biopsy may start to be questioned.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Comparative Study of Image-Guided Excisional Biopsy in High-Risk Non-Palpable Breast Lesions: Predictive Factors for Malignancy

et al. 2015

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Objective: The use of mammography (MM) in breast cancer screening programs has been increasing in recent years. Thus, increasing the number of detected nonpalpable breast cancer patients, through early diagnosis and treatment also increased survival rates. In our study, we wanted to share the factors about imagingguided exicional biopsies for non-palpable breast lesions in postoperative proven breast carcinoma patients. Materials and Methods:The surgical data were reviewed for 83 patients with non-palpabl high-risk breast lesions undergoing imaging-guided surgery in our department between January, 2006 and May, 2011. Histopathologic results and age, ultrasound(US) results, MM image results, BI-RADS categorization, localization of lesion(quadrant) were assessed and factors for predicting malignity were detected.Results: Median age was 52 (age range 32-80 years). 29 (34,9%) of patients were malign in histopathologic results. In four patient, re-excision performed because of positive surgical margins. Axillary examination results were normal in 24 (82,7%) of malignant patients. In MM examination; microcalcifications and nodular opasity were diagnosed in 74,6% of patients before surgery. There were no differance about malignity in these groups after surgery (p:0,428). 59% and 32,7% of patients were BI-RADS 4 and 3, respectively. Postoperative diagnosed malignancies in BI-RADS 4 group were significantly higher than BI-RADS 3 group (p:<0,001). Conclusion:In our study; we concluded that, preoperative BI-RADS categorization (US and MM) is correlated with histopathologic findings after surgery and imaging-guided breast surgery is effective for diagnosis of early-stage breast carcinoma.

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“…Method of localization is widely variable among literature. Masroor et al [10] had done WGL under mammography guidance in 53% of cases and under ultrasound guidance in 40% of the cases. On the other hand, de Roos et al [11] had in their study ultrasound guided localization in 72.6% of patients, mammography guided localization in 26.5%, and MRI guided localization in 0.9% of patients.…”

Section: Discussionmentioning

confidence: 99%

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

El-Bakary¹,

Abdelazim²,

Mawolood³

et al. 2015

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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 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.

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Usefulness of hook wire localization biopsy under imaging guidance for nonpalpable breast lesions detected radiologically

Cited by 14 publications

References 14 publications

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

Preoperative computed tomography-guided hook-wire positioning of pulmonary nodules

A Retrospective Comparative Study of Image-Guided Excisional Biopsy in High-Risk Non-Palpable Breast Lesions: Predictive Factors for Malignancy

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

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