Hookwire Localised Breast Surgery
What is a hookwire localisation?
Many breast lesions can be too small to see or feel. In order to remove these lesions, A/Prof Mak and Dr Graham need guidance to find them in the breast. Using either ultrasound or mammogram to find the lesion, a radiologist inserts a thin wire into the lesion in the breast after local anaesthetic is injected. This wire marks the position of the lesion that needs to be removed. A/Prof Mak and Dr Graham uses this wire to guide them in the surgery.
Hookwire localised breast surgery can be performed for benign (non-cancerous) or malignant (cancerous) lesions in the breast.
When is a hookwire localised breast surgery recommended?
A/Prof Mak or Dr Graham will discuss in detail with you why this surgery is recommended. The common reasons include:
Cancer has been confirmed and the area is being removed as part of a wide local excision or breast conservation surgery
There is an area of abnormality in the breast on imaging and a biopsy has not been possible or has given an inconclusive result
The biopsy has shown an atypical result and more tissue is required for a pathologist to give a definite result
What is involved in a hookwire localised breast operation?
Before the operation – inserting the hookwire
The hookwire will be inserted by a radiologist on the day of surgery. The abnormal area in the breast will be identified with a mammogram or ultrasound and the wire will be placed in that area.
The operation – removing the abnormal tissue and the wire
After the wire is inserted, you will need to go to the perioperative unit/day surgery for your procedure. This will be done in the operating theatre under a general anaesthetic. A/Prof Mak or Dr Graham will follow the wire and remove the wire and the lesion while you are asleep.
The scar that A/Prof Mak or Dr Graham leaves will depend on the size and location of the abnormal tissue as well as your breast shape. She will attempt to make it as neat and hidden as possible, but the most important thing is to adequately remove the lesion and wire.
How long is the operation and what is the recovery like?
Everyone is different, but for most patients the operation takes around 1 hour. When you wake up there will be a waterproof dressing on the wound. Most patients can go home on the same day provided they feel well and have someone at home with them. If you have had another procedure in conjunction with this you may need to stay longer. You will be able to do most things for yourself immediately after the operation.
What are the complications of a hookwire localised breast surgery?
As with all surgical procedures, hookwire localised breast surgery may be associated with complications. Fortunately, these are uncommon and surgery usually proceeds without any problems. A/Prof Mak or Dr Graham will the risks and possible complications with you in detail at your consultation. These complications include but are not limited to pain, bleeding, infection, numbness or decreased sensation, seroma (a collection of fluid in the breast) and the need for further surgery. All lumps that are removed are carefully looked at under the microscope by a pathologist. The need for further surgery will depend on the what the final pathology result is. This takes a week and A/Prof Mak or Dr Graham will discuss the result with you when they see you at your follow up. Very rarely, the abnormal area is not found in the piece of tissue that is removed. If this occurs, A/Prof Mak or Dr Graham will discuss this with you and determine whether you need another procedure.
Alternatives to Hookwire Localisation
There are other technologies that enable A/Prof Mak and Dr Graham to find an abnormal area without using a hook. Scout radar technology uses a small reflector that is about the size of a grain of rice. This can be placed under radiological guidance in the area that needs to be removed at any time before the surgery. It is less likely to move than a hookwire, and generally more comfortable for the patient while waiting for surgery. Speak to A/Prof Mak and Dr Graham if you would like to consider using Scout.
Click here for more information on Scout.
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A/Prof Mak and Dr Graham advocate the National Law and Australian Health Practitioner Regulation Agency (AHPRA) guidelines that any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.