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

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

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

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

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