Wire localisation is a technique which is used when an abnormality has been found on ultrasound scan or mammogram that cannot be felt when the breast is examined. The abnormal area needs to be pinpointed (localised) so that it may be removed for further investigation (biopsy).

The localisation is carried out in the X-ray department with the aid of the mammogram or ultrasound machine just prior to surgery. You will usually be admitted to the ward the day before surgery, and the allowed home the day following surgery.

Ultra-sound guided wire localisation.
This method will be used when possible as it usually causes the least discomfort and is also quicker. You will be positioned on the bed while the radiologist locates the lesion using the ultrasound machine. A local anaesthetic will then be injected into the breast. A very fine wire is inserted, and the ultrasound machine used to ensure that the tip of the wire is positioned as close as possible to the lesion. When the wire is in a satisfactory position; it is usual to take mammogram films from two different angles to confirm the position of the wire in relation to the lesion.

X-ray guided wire localisation.
This method is used to locate microcalcifications or other areas of abnormality that are not detectable by ultrasound. You will be asked to sit facing the mammography machine while the affected breast is positioned using a special localisation compression plate. The breast
lesion is positioned in the centre of this plate and measurements are taken to locate the exact position. Once the position of the lesion has been established a local anaesthetic will be injected into this area of the breast and then a fine wire will be inserted. An x-ray will be taken to confirm that the wire is in a satisfactory position and then a further x-ray
taken to check the position from a different angle.

Following either method, the wire will then be secured and covered with a light dressing and you will usually return to the ward before being taken to the operating theatre. Your x-rays and a radiologists report are taken with you to theatre so they can be referred to during surgery.

The biopsy will be carried out under a general anaesthetic. The surgeon will make a small cut in the skin and use the wire to guide him to the affected area. This area of breast tissue is then excised and sent to be x-rayed to check that abnormality has been satisfactorily removed. The skin is then closed back together with a suture and small paper strips. A
fine drainage tube may placed under the skin to drain any excess fluid collecting in the wound into a plastic bottle. An adhesive transparent dressing will cover the area. The ward nurses will check this regularly and also monitor the amount of drainage into the bottle. It is usual to stay in hospital overnight. The drain will be removed the next morning
providing there is only minimal drainage and then you will be allowed to return home.

The wound dressing can be left in place until you return to clinic. It is impermeable to water so you may wash as usual. If the area becomes painful , reddened or swollen contact the breast care unit or your G.P.

There may be some bruising and aches and twinges in the breast for a week or two. You will be given painkilling tablets to take if needed. You may find you feel more comfortable with the support of a bra day and night. Bra advice can be given if necessary.

You will be given an appointment to return to clinic a week or ten days after your operation when the results will be discussed with you and the wound dressing and suture removed.

The area around the scar may feel firmer or thickened for 2-3 months before it softens.

We gratefully acknowledge the assistance of Sandra Hambleden Senior Radiographer in preparing this information.

If you require further advice or information please contact the
Macmillan Breast Care Nurses, Hazel Ricard and Hilary Rickwood on 020 8565 5885