Pre-Operative Localization

Abstract

Non-palpable, surgical breast lesions require image guidance to direct the site of excision. With the widespread adoption of screening mammography and increased identification of non-palpable breast cancers, image guidance is critical to support the surgeon in successful breast-conserving surgery. Pre-operative localization procedures are typically performed under mammography guidance or ultrasound guidance, and less commonly under magnetic resonance imaging (MRI) guidance. This chapter, appearing in the section on interventions and surgical changes, reviews protocols and pitfalls, pre-/peri-/post-procedure clinical management, and imaging follow-up of pre-operative localization procedures. Topics discussed include mammography-guided, ultrasound-guided, and MRI-guided localization procedures. This chapter also introduces the radioactive seed and radiofrequency identification localization procedures and discusses post-operative specimen radiographs.