TITLE:
Wire-Guided Localization Biopsy for Non-Palpable Suspicious Breast Lesions
AUTHORS:
Tamer A. El-Bakary, S. Abdelazim, Bashdar Ramadan Mawolood, Mohamed S. Hashish
KEYWORDS:
WGL, Non Palpable, Breast Cancer & Excision
JOURNAL NAME:
Surgical Science,
Vol.6 No.7,
July
9,
2015
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.