Is Needle Localization Painful?

Reviewed on 10/20/2020

Needle localization is a technique used for the diagnosis of breast masses that are not felt by hands
Needle localization is a technique used for the diagnosis of breast masses that are not felt by hands

Needle localization is a technique used for the diagnosis of breast masses that are not felt by hands but are seen on routine mammography. It is done prior to a breast biopsy or breast surgery. Its purpose is to locate the exact site of the mass in the breast and help with its removal. The procedure is performed under local anesthesia; hence, there is no pain during the procedure. Most women feel some pressure when the needle is inserted, but there is no significant discomfort or pain. The needle localization procedure is performed by a radiologist.

Why is needle localization done?

Needle localization is the most commonly performed procedure to locate and mark the exact position of any abnormalities in the breast. It can be performed for other parts of the body as well as to locate abnormal tissues. Needle localization is done in the following cases:

  • To locate and remove a tumor or abnormal tissue that is non-palpable (cannot be felt) during a physical examination but visible on radiological tests
  • To remove an abnormal area that is too difficult for the surgeon to locate 
  • To locate and remove a tissue sample if there are multiple abnormalities seen on radiological tests
  • To help the surgeon remove a margin of normal, healthy tissue surrounding the abnormal tissue to ensure that there is no abnormal tissue left behind, reducing the risk of recurrence

How is needle localization performed?

The patient is advised not to use any perfumes or deodorants or apply any powder prior to the procedure. Patients may have to discontinue blood-thinning medications such as aspirin two days before the procedure. Needle localization is done following a mammogram and before a breast biopsy or breast surgery. The breast is cleaned with an antiseptic solution. Local anesthesia is injected to numb the area to minimize discomfort. If the patient is not cooperative or extremely anxious, a sedating agent may be given through the veins.  With the help of a mammogram machine or ultrasound, the radiologist places a thin needle leading up to the mass. Most women may experience tolerable pressure when the needle is inserted. A mammogram is repeated to recheck and confirm the needle position. The needle is then removed, leaving behind a thread-like wire hooked at the site of breast abnormality. The wire is taped as securely as possible to avoid dislodgement. The procedure takes about an hour to complete.

After the procedure: After the needle localization procedure is performed by the radiologist and the wire is in place, the patient is shifted to an operating room or a procedure room where breast biopsy or breast surgery will be done by a surgeon. This procedure is performed under general anesthesia. The surgeon then removes the entire abnormal tissue along with the wire. The breast tissue is then sent for an X-ray to confirm that the entire abnormal tissue has been removed. The excised tissue is then sent to a lab for analysis by a pathologist.

What are the complications of the needle localization procedure?

The procedure is relatively safe. Some possible risks include:

  • Dislodgement of the guidewire before surgery 
  • Bleeding 
  • Swelling
  • Bruising 
  • Infection 
  • Reaction to anesthesia 

QUESTION

A lump in the breast is almost always cancer. See Answer

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References
https://emedicine.medscape.com/article/1844520-overview

https://www.cancer.gov/publications/dictionaries/cancer-terms/def/needle-localization

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