Rare Complication of Stereotactic Guide-Wire Localization of Nonpalpable Breast Lesions: Breakdown of the Wire-The First Series From Turkey Involving 20 Case Analyses

Abstract

BACKGROUND/AIMSIn cases wherein percutaneous biopsy cannot be performed via imaging, a wire-guided breast biopsy is used for the diagnosis of nonpalpable breast cancer. Although known as a safe procedure, complications may develop rarely. In this study, we analyzed 20 cases of instances of guide-wire breakdown that occurred when the procedure was performed.MATERIAL and METHODSWe retrospectively analyzed 818 patients with guide wire-localized breast lesions between January 2015 and June 2017 from electronic files at our hospital.RESULTSWire breakdown occurred in 20 patients. Although the guide wire broke down in the breast specimen of 15 patients (75%), it broke apart from the specimen in 5 patients (25%); 3 of these 5 wires were noticed intraoperatively in the remaining tissue and were removed by re-excision. The remaining 2 wires were noticed using imaging methods during the postoperative period and removed by inserting a second wire. The guide-wire indications in these 20 patients were as follows: microcalcification in 14 (70%); structural distortion in 3 (15%); and focal, asymmetrical area in 3 (15%) patients. Pathology results revealed that the breast specimens were benign in 13 (65%) patients and malignant in 7 (35%) patients.CONCLUSIONAlthough guide-wire breakdown was rarely reported in wire-marked breast biopsies, the frequency is not fully known. Because the wire may breakdown inside the specimen, it can also be found in the remaining breast tissue. Residual wire should be removed by coordinating with the radiologist to prevent possible complications.