19287 Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance

Name of the Procedure:

Placement of Breast Localization Device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), Percutaneous; First Lesion, including Magnetic Resonance Guidance

Summary

This procedure involves the precise placement of a small device in the breast to mark the location of an abnormality. It is done using a needle through the skin, and magnetic resonance imaging (MRI) helps guide the placement.

Purpose

The procedure is primarily used to mark the location of a breast lesion identified during imaging tests. It helps surgeons to accurately locate the lesion during a biopsy or surgery. The goal is to ensure that the targeted area is adequately sampled or removed.

Indications

• Suspicious breast lesions detected through mammograms, ultrasounds, or MRI.
• Preparation for a surgical biopsy.
• Patients with dense breast tissue where abnormalities are not easily palpable.

Preparation

• Fasting might not be required, but follow specific instructions from the healthcare provider.
• Adjustments to medications, particularly blood thinners, may be necessary.
• Diagnostic imaging tests such as MRI or mammography to identify the lesion.
• Inform the medical team about any allergies, medical conditions, or if you are pregnant.

Procedure Description

1. The patient lies on the MRI table.
2. Local anesthesia is administered to numb the breast area.
3. Under MRI guidance, a needle is inserted through the skin to the lesion site.
4. A small localization device, such as a wire or clip, is placed at the lesion.
5. The needle is withdrawn, leaving the device in place.
6. Final imaging is performed to confirm the correct placement of the device.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

It is usually performed in a radiology suite or an outpatient clinic equipped with MRI capabilities.

Personnel

• Radiologist with expertise in MRI
• Radiology technicians
• Nurses

Risks and Complications

• Minor bleeding or bruising at the insertion site
• Infection, though rare
• Discomfort or pain during the procedure
• Potential allergic reaction to anesthesia

Benefits

• Accurate localization of breast lesions for successful biopsy or surgery.
• Minimally invasive with quick recovery time.
• Improved outcomes and accurate treatment planning.

Recovery

• Minimal downtime; most patients can return to normal activities immediately.
• Mild discomfort or soreness at the insertion site may occur.
• Follow-up imaging or surgical procedures are scheduled as needed.
• Instructions may include keeping the insertion site clean and dry.

Alternatives

• Stereotactic or ultrasound-guided biopsy.
• Observation and follow-up imaging if the lesion does not warrant immediate intervention.
• Each alternative has its pros and cons, typically balancing between invasiveness, accuracy, and patient comfort.

Patient Experience

• Patients may feel pressure or minor pain during needle insertion due to local anesthesia.
• Post-procedure soreness is common but manageable with over-the-counter pain medication.
• Overall, it is quick and involves minimal discomfort, and you can usually go home the same day.