BREAST EXCISION / HOOKWIRE

WHAT IS BREAST EXCISION?

  • Lumpectomy

  • May be for diagnostic purposes or alternatively to remove a potentially harmful area of breast tissue

  • In context of breast cancer removal, may be termed wide local excision

 

WHAT IS A HOOKWIRE?

  • Not all breast lesions can be felt by you and/or your surgeon from the surface – these lesions may be very small, very deep or not actually forming a lump

  • If a breast lesion is to be excised but is impalpable, that is, cannot be felt by your surgeon, s/he may use hookwire localisation before the operation to aide accurate removal of the breast lesion

  • A hookwire is a thin wire placed into the breast under ultrasound or mammogram guidance so the wire tip is next to the breast lesion – this acts as a guide for your surgeon to the area of concern

 

HOW IS HOOKWIRE LOCALISATION PERFORMED?

  • Most hookwire localisation utilises ultrasound guidance for accurate hookwire placement

  • If a breast lesion is invisible on ultrasound, mammogram guided hookwire placement may be required

  • Hookwires may be placed by a radiologist in the X-ray department under local anaesthetic and with you awake, prior to surgery – the external wire component will be securely taped down so the wire does not move between placement and surgery

  • Sometimes, your surgeon will place the wire under ultrasound guidance, with you asleep in the operating room, immediately prior to surgery

 

IS A HOOKWIRE OPERATION DIFFERENT TO STANDARD "LUMPECTOMY"?

  • Apart from the surgeon using the hookwire to guide him/her to the abnormal area, not really

  • Hookwire localised breast excisions are usually X-rayed or ultrasounded during your operation to confirm accurate removal of the targeted breast lesion

  • Post operative recovery is as for a standard breast excision

 

DO HOOKWIRE LOCALISED BREAST EXCISIONS EVER FAIL?

  • Occasionally placing a hookwire close to the targeted breast lesion may prove technically challenging or even impossible; in these situations, your surgeon will develop an alternate strategy

  • In about 2% of cases, even with successful hookwire localisation, the surgically removed breast tissue may not subsequently yield the targeted lesion – this may necessitate a second operation

HOOKWIRE LOCALISATION ALLOWS ACCURATE REMOVAL OF BREAST LESIONS WHICH CANNOT BE CLEARLY FELT BY THE SURGEON PRE-OPERATIVELY

Melbourne Breast and Endocrine Surgeons Mr Sunil Jassal
Royal Australasian College of Surgeons Mr Sunil Jassal
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Sunil Jassal Breast and General Surgeon

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