Needle Localization
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Our radiologists perform localization procedures to prepare patients for breast surgery. After consultation with your breast surgeon, the radiologist can mark the area to be removed during surgery either with a small metallic reflector clip called a SAVI SCOUT or with a thin wire. A SAVI SCOUT can be placed before the day of your surgery; a wire must be placed on the morning of the surgery.
SAVI SCOUT Localization
A SAVI SCOUT is a metallic reflector about the size of a grain of rice that is placed inside the breast in the tissue that needs to be removed. It cannot be seen from the outside and is not something you can feel once it is placed. In the operating room, your surgeon will use nonradioactive radar waves to detect it in your breast. This will guide him or her to the location of the abnormal tissue that requires removal. The radiologist can place the SAVI SCOUT in the breast using ultrasound or mammographic guidance. The appropriate imaging guidance is tailored to each individual case.
How do I get ready for the test?
No special preparation is needed for a SAVI SCOUT placement. Please eat normally leading up to your procedure and take your medications as usual. If you have had prior mammograms, breast ultrasounds, or breast MRIs performed at a non-NYP office, bring these to your appointment on a CD.
What will happen during the test?
After you arrive and check in, you will undress from the waist up and change into a gown. One of our experienced technologists will escort you into a breast ultrasound or mammography room. The technologist and/or doctor performing the procedure (a breast radiologist) will explain the procedure, and you will have a chance to ask questions. If your procedure will be performed with ultrasound guidance, you will lie on your back on the ultrasound table. If possible, we will ask you to raise your arm and place it behind your head. Together, we will find a position that is comfortable for you. If your procedure will be performed with mammographic guidance, the technologist will position your breast in the mammography machine. In most cases, you will remain seated in a chair.
The radiologist will clean the skin of the breast with a special cleanser. He or she will use a small needle to inject a numbing medication into the breast at the site being marked. Once the area is numb, the radiologist will use the images on the ultrasound monitor or the mammogram pictures to guide a needle to the area. Once the position of the needle is confirmed on the ultrasound or mammogram images, the SAVI SCOUT will be placed through the needle. The needle will be removed.
When the procedure is complete, a special detector unit, similar to the one your surgeon will use in the operating room, will be used to confirm the signal from the SAVI SCOUT. A small bandage is applied. The staff will review the post-care instructions with you. We recommend that you avoid heavy lifting or exercise and any activity that submerges the breast under water (swimming pool, bath tub) for three days. You may shower 24 hours after the procedure.
This procedure usually takes about 30 minutes. Before you leave, the technologist may take two regular mammogram pictures of the breast for the surgeon to use in the operating room.
Are there any risks?
SAVI SCOUT localization has a very small risk of bleeding or infection. There are very rare reports of allergic reactions to the nickel within the SAVI SCOUT in patients with severe nickel allergy. Patients with a severe nickel allergy should discuss alternatives with their doctors.
After the test
Follow up with your breast surgeon to confirm the details of your planned surgery.
Wire Localization
A wire localization can be performed by a breast radiologist on the morning of your breast surgery to guide your surgeon to the tissue that needs to be removed. The wire is placed into the breast via a thin needle. The surgeon will follow the visible portion of the wire into the breast to find the area that needs to be removed. The wire can be placed using ultrasound or mammographic guidance. A portion of the wire will be within the breast, and a portion will be visible from outside of the breast. The appropriate imaging guidance is tailored to each individual case.
How do I get ready for the test?
No special preparation is needed for a wire localization procedure but most patients require special preparation for the surgery itself. Review the preparation required for your surgery with your breast surgeon.
What will happen during the test?
After you arrive and check in, you will undress from the waist up and change into a gown. One of our experienced technologists will escort you into a breast ultrasound or mammography room. The technologist and/or doctor performing the procedure (a breast radiologist) will explain the procedure, and you will have a chance to ask questions. If your procedure will be performed with ultrasound guidance, you will lie on your back on the ultrasound table. If possible, we will ask you to raise your arm and place it behind your head. Together, we will find a position that is comfortable for you. If your procedure will be performed with mammographic guidance, the technologist will position your breast in the mammography machine. In most cases, you will remain seated in a chair.
The radiologist will clean the skin of the breast with a special cleanser. He or she will use a small needle to inject a numbing medication into the breast at the site being marked. Once the area is numb, the radiologist will use the images on the ultrasound monitor or the mammogram pictures to guide a needle to the area. Once the position of the needle is confirmed on the ultrasound or mammogram images, the wire will be placed through the needle. The needle will be removed.
When the procedure is complete, the technologist will place a bandage to cover the portion of the wire that is outside of the breast. While the wires are designed not to move, we recommend minimizing movement of the arm on the side on which the wire was placed. A staff member will escort you and anyone accompanying you to the pre-operative area or to nuclear medicine if you require additional pre-surgery tests.
Are there any risks?
Wire localization has a very small risk of bleeding or infection. In rare cases, the wire can migrate within the tissues.
After the test
Follow up with your breast surgeon following your surgery. Your surgeon will determine any appropriate next steps.