J Surg Ultrasound.  2022 Nov;9(2):36-41. 10.46268/jsu.2022.9.2.36.

Ultrasonography-Guided Breast Tissue Marker Insertion

• Kang T
• Park H
• Kim KE

• KMID: 2538383
• DOI: http://doi.org/10.46268/jsu.2022.9.2.36

Abstract

Recently, Non-palpable lesion detection has been increasing in breast cancer management due to early detection and better response of neoadjuvant treatment. Therefore, localising the lesions more accurately in real-time with minimal tissue injury has assumed greater importance. Traditionally, mammography-guided wire localization has been the most commonly used technique. However, tissue injury might be inevitable when the distance between wire insertion and the lesion is far, as accurate 3-dimensional localization is not easy, and scheduling for the procedure delays the time of the surgery. Therefore, ultrasonographyguided wire localization is a useful method, as many surgeons routinely use ultrasonography in their clinics in Korea. However, it is not easy to find the marker as predicted when breast lesions disappear after neoadjuvant treatment, and this procedure needs to be scheduled just prior to surgery. This review article discusses practical aspects and multiple approaches using tissue markers to enhance the localization of non-palpable lesions.

Keyword

Ultrasonography; Localization; Breast neoplasms; Interventional Procedures

Figure

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  Fig. 1 47-year-old female, Rt. 3 o’clock Breast Invasive ductal cancer, cT2N0 or 1, ER/PR/c-erb B2/ki-67 (0/0/-/95%). (A) Ultrasonogram at Diagnosis shows 2 × 1.3 × 2.4 cm irregular heterogenous hypoechoic mass. (B) Ultrasonogram during Neoadjuvant Chemotherapy (NAC) of AC+Td regimen, a marker was inserted in the middle of decreasing lesion. (C) US after NAC shows only architectural distortion. The marker is hard to be shown. (D) Specimen mammogram after Mammo-guided localized excision. The marker is well included in the specimen, just near the wire.

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