Efficacy of Hooked-Wire Needle Localization for Nonpalpable Breast Lesions

ABSTRACT

PURPOSE: The more frequent use of screening mammography, along with improved imaging equipment and techniques, is today resulting in an increasing detection rate for suspicious nonpalpable lesion and thus an increasing need for needle localizations and biopsies. We evaluate the efficacy of hooked-wire fine needle localization. METHODS: From August 1992 to August 1999, 146 hooked-wire needle biopsies were performed at our institution for nonpalpable mammographically detected abnormalities. Specimen roentgenographies were done in all cases. The clinical datas, including mammographic findings and pathologic results, were reviewed retrospectively. RESULTS: Patients ranged in age from 13 to 74 years (a mean of 45.7 years). Of the total 146 cases, 23 (15.7%) were found to be malignants (52.2 percent of these malignancies were carcinomas in situ and 47.8 percent were invasive carcinoma). The chance of a biopsy containing a malignant lesion was 17.2 percent if the biopsy was done for a microcalcification found on a mammograms, 7.7 percent for mass densities, and 28.6 percent if both were present. Benign pathological lesions were proven in 123 cases (84.3%) of the total 146 cases. The most common benign lesion was fibrocystic disease. A minor complication of the hooked-wire needle insertion occurred in one patient who had a hematoma requiring evacuation. Three patients experienced faintness, dizziness, and syncope during needle localization. The morbidity and the mortality rates for biopsies of the breast were nil. CONCLUSION: These results suggest that hooked-wire needle localization for nonpalpable lesion in the breast is a most useful diagnostic modality.