Needle (Wire) Localization Biopsy

What is Needle Localization Biopsy ?

This type of biopsy is performed when you have an abnormality seen on a mammogram that cannot be felt. It is an outpatient biopsy that is done in two steps on the same day.

How do I prepare for this exam?

  • If you did not have your previous mammograms at UCSF Medical Center, you must bring your previous mammograms with you. If you call the facility where it was performed, they will tell you how to obtain these images on film. If the facility offers a CD of the images, please ask them to print out film images. The radiologist compares the images from prior exams to the current exam to assist in the interpretation. In general, the UCSF Radiologist will want to compare your last five years of mammogram films to the results of the scheduled mammogram.
  • Do not wear talcum powder, deodorant, lotion or perfume under your arms or on your breasts. These substances can cause artifacts making the images harder to interpret.
  • Wear two-piece clothing so that you only have to remove your top and bra for the examination.
  • Jewelry worn should be easily and quickly removable.
  • You may be asked to complete a brief breast health questionnaire.

What happens and how long does it take?

Step I - Radiology: To Find the Abnormal Tissue

In a sitting or standing position, your breast will be positioned for a mammogram to find the exact location of the abnormal tissue. Once the area is identified, a radiologist will numb your breast with a local anesthetic. A needle is inserted and a small wire threaded through the needle. The tip of the needle is placed near the abnormal tissue. Accurate placement of the wire is checked by mammogram. The wire is securely taped in place. This procedure can take up to one hour to perform.

Most women report no pain, but feel pressure and pulling. Some women feel faint or dizzy. If you have any unusual symptoms or sensations, tell the Technologist assisting you or your Radiologist so they can help you. 

Step II -- Same Day Surgery: To Biopsy the Abnormal Tissue

During this biopsy, the abnormality identified on a mammogram is surgically removed. Anesthesia that you and your physician have discussed is administered. A surgeon uses the wire implanted earlier to locate the abnormal tissue and remove it. The tissue is sent to radiology to be X-rayed. The Radiologist and Surgeon will confirm that the tissue found on the mammogram was removed. Most women experience no change in the breast beyond a surgical scar. You will feel some lumpiness near the incision from scar tissue. Some patients experience some pain, swelling and discomfort, which subsides in a few days. 

You will be brought by wheelchair from radiology, where the wire was inserted, to same day surgery. Family or friends may be with you before and after the wire localization, but not during the procedure. 

The biopsy is an excisional biopsy, meaning that the abnormality seen on mammogram is surgically removed. You will be given the anesthesia that you and your physician have discussed. The Surgeon uses the wire to locate the abnormality and remove it in the operating room. The specimen, once removed from the breast, is then sent to radiology to be X-rayed. The Radiologist and the Surgeon communicate to confirm that the abnormality seen on mammogram has been removed. 

There will be a scar on the breast after the biopsy. In general, your Surgeon will be able to tell you where the incision (or scar) is expected to be on your breast. Most women do not experience a marked change in the appearance of the breast beyond the surgical scar. The swelling and bruising that you may experience will resolve. You will, however, be able to feel lumpiness near the surgical site from scar tissue after the biopsy. The time that the surgery takes can vary. Ask your Surgeon to give you an estimate of how long the procedure will take. 

This procedure is generally well tolerated and most patients return to their full range of activities by the next day. However, occasionally there are patients who experience considerable pain, swelling and discomfort after this procedure. These symptoms should be reported to your doctor. 

Who performs this exam?

The Technologist will perform the mammogram. The Radiologist will place the needle in your breast. Your surgeon performs the biopsy. 

Will my insurance cover this exam?

Most insurance plans cover this exam but you should check with your insurance carrier to be certain. If you have HMO insurance, check with your plan to make sure that UCSF Medical Center is in your provider network. 

How do I schedule this exam?

Call (415) 353-9800. The scheduling department is open from 8 am – 4:30 pm, Monday through Friday. 

Where do I go to have this exam?

1600 Divisadero Street, 2nd floor , Room H2906, San Francisco 

 

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