Image-Guided Needle Localization

If your surgeon decides that you need an open surgical biopsy, you may need either mammography-assisted, stereotactic, ultrasound-assisted or MRI-assisted needle localization.

For this to happen, your surgeon will mark the area where the tissue is to be removed prior to surgery. Then during wire localization, a radiologist will identify the abnormality and insert a thin wire through the center of the needle to indicate the exact area to be removed.

The wire is removed at the time of the excision and the tissue is sent to pathology.

Prior to any procedure, a nurse will meet with you to complete an assessment, explain the procedure and provide you with the appropriate paperwork. The radiologist will then meet with you to answer any questions you might have and have you sign consent forms for the procedure. Based on the procedure, you may or may not receive an IV.

Mammography-Guided Needle Localization
This procedure is performed using mammographic guidance with you sitting in a specially designed chair. The technologist will help you get into a position that is the most comfortable for you and guide the breast between the two plates; one plate will have an opening for access to the breast. The breast is then compressed as with a mammogram and an image is obtained to find the area of concern.

After a local anesthetic is injected into your breast, the radiologist inserts the needle into the breast and another image is taken to check position. The wire is guided through the needle and left in the breast through the area of concern. The needle is then removed from the breast and the wire is secured in place. Often, a mammographic image is taken to further guide the surgeon.

The nurse will cover the area and take you to surgery by wheelchair, where the remainder of your procedure will be done under the care of the surgical staff and your surgeon.

Stereotactic-Guided Needle Localization
This procedure is performed using mammographic guidance with you lying on your stomach on a special table. The technologist will help you get into a position that is the most comfortable for you and guide the breast through a hole in the table. The breast is then compressed as with a mammogram and a sequence of images is obtained to find the area of concern.

Local anesthetic is then injected into your breast, and additional images are obtained to guide the biopsy. The radiologist inserts the needle into the breast and takes images of the area of concern. The wire is guided through the needle and left in the breast through the area of concern. The needle is then removed from the breast and the wire is secured in place. Often, a mammographic image is taken to further guide the surgeon.

The nurse will cover the area and take you to surgery by wheelchair, where the remainder of your procedure will be done under the care of the surgical staff and your surgeon.

Ultrasound-Guided Needle Localization
This procedure is performed using ultrasound guidance with you lying on your back on a padded table. Warm gel is placed on your breast and the technologist scans to locate the area of concern.

The radiologist will then clean the area with an antiseptic and inject local anesthetic into your breast. The radiologist inserts the needle into the area of concern. The wire is guided through the needle and left in the breast through the area of concern. The needle is then removed from the breast and the wire is secured in place. A mammographic image is taken to further guide the surgeon.

The nurse will cover the area and take you to surgery by wheelchair, where the remainder of your procedure will be done under the care of the surgical staff and your surgeon.

MRI-Guided Needle Localization
This procedure is performed using MRI guidance with you lying on your stomach with your head slightly elevated on a special table. The technologist will help you get into a position that is the most comfortable for you. The table has openings to accommodate your breasts. Your breasts will be positioned between a plate and a grid with light compression. You may use earplugs or headphones and listen to music during the scan to drown out the loud sound from the magnet.

After the breast is scanned and the area of concern located, the radiologist will then clean the area with an antiseptic and inject local anesthetic into your breast.

The radiologist inserts the needle into the area of concern. An MRI scan verifies the needle location. The wire is guided through the needle and left in the breast through the area of concern. The needle is then removed from the breast and the wire is secured in place. A mammographic image is taken to further guide the surgeon.

The nurse will cover the area and take you to surgery by wheelchair, where the remainder of your procedure will be done under the care of the surgical staff and your surgeon.

Gwinnett Medical Center Imaging has multiple convenient Atlanta-area locations in Lawrenceville, Hamilton Mill and Duluth. If you would like to schedule an appointment, please call 678-312-3444.