Sometimes a surgeon requires us to localise an area that needs to be removed surgically.
This occurs if the area is not palpable, meaning the surgeon cannot feel it.
We use two methods to do this, and the surgeon will choose the most appropriate method for their requirements in the operating theatre. Details on the two methods are below.
A small amount of carbon (charcoal in suspension) which looks like ink, is injected into the breast. This is done using ultrasound or mammography. The radiologist and mammographer/sonographer use ultrasound or mammography to guide the tip of the needle to the correct area, and the carbon is injected as the needle is removed, leaving a track of carbon in the breast tissue. It is a quick, simple procedure. A local anaesthetic is used to reduce discomfort, and no preparation is needed. A bandaid is used after the procedure, and there are no further post-procedure instructions.
For various reasons, a surgeon may prefer the use of a hookwire to guide the surgeon to the area requiring removal. A very fine wire is inserted into the breast through a needle. This is usually done on the day of surgery after you are admitted to hospital and is done using ultrasound or mammography. The radiologist and mammographer/sonographer use ultrasound or mammography to guide the tip of the needle to the correct area. The wire is inserted through the needle. A local anaesthetic is used before the procedure. The wire will be taped to the breast and covered with a dressing, after which two mammogram pictures will be taken to show the position of the wire. You will then be returned to the ward or to the theatre to prepare for surgery.
It is very important to bring relevant previous mammogram and ultrasound imaging with you to the appointment to help with this localisation.
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