Single-step ultrasound localization of breast lesions and lumpectomy procedure

Background This review was made to evaluate whether the efficiencies of intraoperative ultrasound-guided localization could be extended to stereotactic biopsy cases by using a marker visible by sonography and mammography. Methods A retrospective review identified 170 stereotactic directional vacuum-assisted biopsy (DVAB) procedures marked with an ultrasound-visible marker. Localization device, imaging method, lesion retrieval, and margin status were assessed for patients having subsequent lumpectomy or wider excision. Results Nineteen of 170 patients underwent lumpectomies (12) or wider excision (7) localized by a radiofrequency device or 18G needle up to 7 weeks after stereotactic biopsy. In 15 of 19 procedures, an ultrasound-guided localization was performed intraoperatively, targeting the marker. All targeted lesions were successfully excised. In the 13 malignant lesions (of 19 surgeries), only 1 had a positive margin (8%). Conclusions Marking stereotactic biopsies with a sonographically visible marker allows ultrasound-guided intraoperative localization, improving efficiencies for the patient, surgeon, and operating room schedule.