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Preoperative Lesion Localization, Bracketing
Reni Butler, MD; Wendie A. Berg, MD, PhD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          TERMINOLOGY

          • Definitions

            • Image-guided localization of larger nonpalpable malignancy, using ≥ 2 wires or seeds, prior to surgery
              • Assists surgeon in excising entire lesion by delineating extent of abnormality, generally used for nonpalpable and/or multiple malignant lesions
                • Lower reexcision rates of larger cancers with multiple vs. single wire localizations; 28% vs. 36% (1 series)
              • Bracketed localization ↓ volume of tissue excised relative to solitary localization of larger lesions
              • Mammographic, tomosynthesis, US, MR, or ductographic guidance

          PREPROCEDURE

          • Indications

            • Contraindications

              • Getting Started

                PROCEDURE

                • Patient Position/Location

                  • Procedure Steps

                    • Alternative Procedures/Therapies

                      POST PROCEDURE

                      • Expected Outcome

                        OUTCOMES

                        • Complications

                          Selected References

                          1. Da Silva M et al: Bracketed radioactive seed localization vs bracketed wire-localization in breast surgery. Breast J. 24(2):161-6, 2018
                          2. Jadeja PH et al: Utilization of multiple SAVI SCOUT surgical guidance system reflectors in the same breast: A single-institution feasibility study. Breast J. 24(4):531-34, 2018
                          3. Janssen NNY et al: Breast conserving surgery for extensive DCIS using multiple radioactive seeds. Eur J Surg Oncol. 44(1):67-73, 2018
                          4. Malhaire C et al: Outcome of oncoplastic breast-conserving surgery following bracketing wire localization for large breast cancer. Breast. 24(4):370-5, 2015
                          5. Javid SH et al: Outcome of multiple-wire localization for larger breast cancers: do multiple wires translate into additional imaging, biopsies, and recurrences? Am J Surg. 198(3):368-72, 2009
                          6. Kirstein LJ et al: Outcomes of multiple wire localization for larger breast cancers: when can mastectomy be avoided? J Am Coll Surg. 207(3):342-6, 2008
                          7. Burkholder HC et al: Breast surgery techniques: preoperative bracketing wire localization by surgeons. Am Surg. 73(6):574-8; discussion 578-9, 2007
                          8. Cordiner CM et al: Does the insertion of more than one wire allow successful excision of large clusters of malignant calcification? Clin Radiol. 61(8):686-90, 2006
                          9. Bassett LW et al: Diseases of the Breast. 2nd ed. Philadelphia: Elsevier Saunders. 266, 2005
                          10. Wallace AM et al: Rates of reexcision for breast cancer after magnetic resonance imaging-guided bracket wire localization. J Am Coll Surg. 200(4):527-37, 2005
                          11. Liberman L et al: Bracketing wires for preoperative breast needle localization. AJR Am J Roentgenol. 177(3):565-72, 2001
                          Related Anatomy
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                          Related Differential Diagnoses
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                          References
                          Tables

                          Tables

                          KEY FACTS

                          • Terminology

                            • Preprocedure

                              • Procedure

                                • Post Procedure

                                  TERMINOLOGY

                                  • Definitions

                                    • Image-guided localization of larger nonpalpable malignancy, using ≥ 2 wires or seeds, prior to surgery
                                      • Assists surgeon in excising entire lesion by delineating extent of abnormality, generally used for nonpalpable and/or multiple malignant lesions
                                        • Lower reexcision rates of larger cancers with multiple vs. single wire localizations; 28% vs. 36% (1 series)
                                      • Bracketed localization ↓ volume of tissue excised relative to solitary localization of larger lesions
                                      • Mammographic, tomosynthesis, US, MR, or ductographic guidance

                                  PREPROCEDURE

                                  • Indications

                                    • Contraindications

                                      • Getting Started

                                        PROCEDURE

                                        • Patient Position/Location

                                          • Procedure Steps

                                            • Alternative Procedures/Therapies

                                              POST PROCEDURE

                                              • Expected Outcome

                                                OUTCOMES

                                                • Complications

                                                  Selected References

                                                  1. Da Silva M et al: Bracketed radioactive seed localization vs bracketed wire-localization in breast surgery. Breast J. 24(2):161-6, 2018
                                                  2. Jadeja PH et al: Utilization of multiple SAVI SCOUT surgical guidance system reflectors in the same breast: A single-institution feasibility study. Breast J. 24(4):531-34, 2018
                                                  3. Janssen NNY et al: Breast conserving surgery for extensive DCIS using multiple radioactive seeds. Eur J Surg Oncol. 44(1):67-73, 2018
                                                  4. Malhaire C et al: Outcome of oncoplastic breast-conserving surgery following bracketing wire localization for large breast cancer. Breast. 24(4):370-5, 2015
                                                  5. Javid SH et al: Outcome of multiple-wire localization for larger breast cancers: do multiple wires translate into additional imaging, biopsies, and recurrences? Am J Surg. 198(3):368-72, 2009
                                                  6. Kirstein LJ et al: Outcomes of multiple wire localization for larger breast cancers: when can mastectomy be avoided? J Am Coll Surg. 207(3):342-6, 2008
                                                  7. Burkholder HC et al: Breast surgery techniques: preoperative bracketing wire localization by surgeons. Am Surg. 73(6):574-8; discussion 578-9, 2007
                                                  8. Cordiner CM et al: Does the insertion of more than one wire allow successful excision of large clusters of malignant calcification? Clin Radiol. 61(8):686-90, 2006
                                                  9. Bassett LW et al: Diseases of the Breast. 2nd ed. Philadelphia: Elsevier Saunders. 266, 2005
                                                  10. Wallace AM et al: Rates of reexcision for breast cancer after magnetic resonance imaging-guided bracket wire localization. J Am Coll Surg. 200(4):527-37, 2005
                                                  11. Liberman L et al: Bracketing wires for preoperative breast needle localization. AJR Am J Roentgenol. 177(3):565-72, 2001