Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance
CPT4 code
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
- The patient lies on the MRI table.
- Local anesthesia is administered to numb the breast area.
- Under MRI guidance, a needle is inserted through the skin to the lesion site.
- A small localization device, such as a wire or clip, is placed at the lesion.
- The needle is withdrawn, leaving the device in place.
- 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.