19285 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance

Name of the Procedure:

Placement of Breast Localization Device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), Percutaneous for First Lesion, Including Ultrasound Guidance

Summary

This procedure involves placing a small device, such as a wire, clip, or radioactive seed, into the breast tissue to mark the location of an abnormality. This helps guide surgeons during biopsy or surgery. Ultrasound is used to accurately place these devices.

Purpose

The procedure marks or localizes breast abnormalities found in imaging tests. This aids in precisely targeting areas during surgical biopsies or lumpectomies, ensuring that any suspicious or problematic tissue is correctly identified and removed.

Indications

• Suspicious areas or lesions found through mammograms or ultrasound
• Need for precise localization of breast abnormalities for surgical planning
• Patients undergoing biopsies or lumpectomies to remove or diagnose breast tissue

Preparation

• Patients may need to avoid eating or drinking for a certain period before the procedure.
• They should inform their doctor of any medications, allergies, or medical conditions.
• Diagnostic imaging, like mammograms or ultrasounds, will be reviewed to locate the lesion.

Procedure Description

1. The patient is positioned comfortably, and the breast area is sterilized.
2. Local anesthesia is administered to numb the biopsy area.
3. Using ultrasound guidance, the healthcare provider inserts a needle through the skin into the breast tissue.
4. The localization device (clip, seed, wire, etc.) is placed through the needle into the precise location of the lesion.
5. The needle is then removed, leaving the device in place.
6. Confirmation imaging may be performed to ensure accurate placement.

Duration

The procedure typically takes around 30 to 60 minutes.

Setting

The procedure is usually performed in an outpatient clinic, radiology department, or surgical center.

Personnel

• Radiologist or breast surgeon
• Ultrasound technician
• Nurses

Risks and Complications

• Bleeding or bruising at the insertion site
• Infection
• Discomfort or pain
• Rarely, improper placement requiring repositioning

Benefits

• Provides an accurate guide for surgical biopsies or lumpectomies
• Helps ensure complete removal of abnormal tissue
• Minimally invasive with quick recovery

Recovery

• Patients can typically return to normal activities the same day.
• They may experience mild soreness, managed with over-the-counter pain relievers.
• Follow-up imaging or appointments may be necessary to monitor the site.

Alternatives

• Stereotactic mammogram-guided needle localization
• MRI-guided localization
• Watchful waiting with regular imaging for monitoring

Pros and cons of alternatives depend on lesion location, size, and patient health.

Patient Experience

• Patients will feel initial needle prick for anesthesia, followed by little to no pain during device placement.
• They may experience mild pressure or discomfort during the procedure.
• Post-procedure, mild soreness or bruising is possible but generally manageable with mild pain relievers.