Ultrasound Guided Intraoperative Wire Localization Under General Anesthesia in Breast-Conserving Surgery

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 7; p. e41662
• Main Authors: Vartanian, Artin, Papas, Paraskevi V, Guarecuco Castillo, Jesus E, Sistare, Michael, Masri, Mohammed M
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 10.07.2023; Cureus
• Subjects: Anesthesiology; Anxiety; Breast cancer; Cancer therapies; General anesthesia; General Surgery; Localization; Lumpectomy; Mammography; Oncology; Outpatient care facilities; Pathology; Postoperative period; Scheduling; Surgeons; Surgery; Sutures; Teams; Ultrasonic imaging; United States > US; ultrasound guided imaging; tumor localization; breast cancer treatment; breast-conserving surgery; breast cancer; wire localization; intraoperative ultrasounds
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.41662

Breast-conserving surgery (BCS) is becoming an increasingly preferred surgical technique for treating breast cancer. For the last several decades, using a preoperative wire placed by a radiologist has been the gold standard to help guide surgeons to excise a suspicious mass. In recent years, there has been an increasing focus on using surgeon-performed intraoperative ultrasound (IOUS) during breast-conserving therapy, suggesting improved cosmetic outcomes and a decreased need for re-excision. However, studies have also highlighted that ultrasound may be uncomfortable for surgeons who have become most familiar with a wire-localization technique. Wire localization and intraoperative ultrasound are valuable tools that can improve the accuracy of tumor localization and reduce the need for re-excision. We present a 45-year-old female with a right breast mass, measuring breast imaging reporting and data system (BIRADS) 4A on preoperative ultrasound. Intraoperative wire-localization was performed by the surgeon utilizing ultrasound guidance. The right breast lesion was successfully excised with negative margins. The patient was discharged home and recovered well. Surgeon-performed intraoperative ultrasound can be combined with surgeon-performed wire localization to reduce the need for re-excision surgery and allow the surgeon to retain the familiarity of utilizing a gold-standard technique. Further research is needed to determine the optimal use of surgeon-performed IOUS and wire-localization, and its impact on long-term outcomes.