Needle Localization Breast Biopsy

Published in FromWithin, Oak Leaf newsletter, November 1998.

For the first time at HealthSouth Oak Leaf Surgery Center, an x-ray guided breast biopsy was performed using a portable mammography unit. General surgeon Steven Immerman, M.D., performed the procedure along with a radiologist, a mammography technician, an anesthesiologist, and a registered nurse. This procedure is for biopsy of breast abnormalities that show up on mammograms but cannot be felt on physical exams. The procedure is called a "localization biopsy".

When this procedure is done in a hospital, a patient would first go to the radiology department to have a needle with a guide wire inserted into her breast to locate the area of concern. The patient, with the needle still inserted in her breast, would then travel to a different hospital department to be prepped for the actual surgery. Often, the radiologist who inserted the guide wire and the surgeon who performed the surgery have little opportunity to communicate during the procedure. The patient in the meantime would often experience long waits between the different stages of the procedure. The anesthesiologist is not involved until the patient comes to the operating room.

The localization biopsy procedure at HealthSouth Oak Leaf Surgery Center is streamlined to make the procedure go quickly and smoothly for the patient. When a patient comes to the center for a localization biopsy, she is brought directly to the procedure room - and remains there until the biopsy is completed. The anesthesiologist is present throughout the procedure to insure the patient's comfort. The radiologist begins the procedure by administering local anesthetic and placing a needle in the breast, guided by the Sophie mammography unit. Once the needle is in the exact spot that requires biopsy, a small amount of blue dye is injected to mark the spot, and a small guide wire is left in place to guide the surgeon to the questionable area in the breast.

Once the abnormality is "localized", the patient is placed on the operating room table, and additional sedation is given if needed. The surgeon makes an incision on the breast, and follows the guide wire down to the area marked with the blue dye. A biopsy of this area is then taken and sent to the pathologist for processing. Sometimes a diagnosis can be obtained by frozen section before the patient even leaves the room. By performing the procedure in one operating room, the anesthesiologist, surgeon, radiologist and pathologist all have a chance to work together to coordinate the patient's care.

Dr. Immerman feels that the addition of mammography to the surgery center's capabilities allows virtually all types of diagnostic and therapeutic breast surgery to be performed at the HealthSouth Oak Leaf Surgery Center. He is especially pleased by the quality of the images, and the fact that the unit is portable - allowing a second patient to be "localized" while the first one is having a biopsy.

However, the most important advantage of this procedure has to do with the treatment of the patient. As Sue, the first patient to have experienced this simpler procedure, shares, "It is so nice to be able to have the entire procedure done in one place without having waiting time between steps."

All members of the HealthSouth Oak Leaf Surgery Center team recognize how the needle localization of a breast lesion has become much less invasive and more of a team effort because of the surgery center's use of the Sophie Planmed mammography unit.

For further information, contact Evergreen Surgical at 832-1044.

Published in FromWithin, Oak Leaf newsletter, November 1998.