Hookwire Localisation

Mammography, ultrasound and magnetic resonance imaging (MRI) examinations can identify abnormalities in the breast that cannot be felt by a doctor.

If the abnormality is to be surgically removed, it is necessary to place a fine wire (called a hookwire), into the breast with its tip at the site of the abnormality. The wire acts as a marker during surgery and enables the surgeon to identify the correct area of breast tissue. Mammography, ultrasound or MRI scans are used to guide the hookwire into the correct position.

The wire is called a hookwire because there is a tiny hook at the end, which keeps it in position.

A referral from your doctor and an appointment are required for this procedure.

Usually, this procedure will be performed a few hours before you have surgery. There is no preparation required for the hookwire localisation, but there will be preparation for the surgery that follows the hookwire localisation.

Preparation instructions/information for the surgery will provided to you by your surgeon.

Before the procedure you be asked to remove all jewellery and clothing from the waist up, and change into a loose fitting examination gown.

The skin of the breast will then be washed with antiseptic before a very fine needle is used to give local anaesthetic to numb the breast in the area for biopsy.  The local anaesthetic may sting for a few seconds when it is being given, and after this the area will become numb.

The radiologist will then insert a fine needle into the tissue to be removed. Images will be taken to check the position of the needle, once it is in the correct position, a fine wire is passed through the centre of the needle and the needle is removed, leaving the hookwire in place. A final set of images will be taken to show the surgeon where the tip of the wire lies in relation to the abnormality that is to be removed.

Hookwire localisation is a simple procedure to perform and most women will experience no problems. Problems that can occur on rare occasions are:

• Movement of the hookwire after placement and before surgery is performed (which reduces the accuracy of the surgery), and
• Wire dislodgement. This occurs usually because the breast is composed of fatty tissue which provides a poor grip for the hookwire).

If you are travelling to another facility for your surgery with a hookwire in position, you need to take care. Dislodgement may occasionally occur with very little movement. If dislodgement occurs, you may need to have the procedure repeated because the tip of the wire will no longer be situated in the lesion that needs to be removed.

At Apex Radiology your hookwire localisation procedure will be performed by a radiologist (a doctor specialising in medical imaging), who will send a report to your surgeon detailing the procedure that has been performed.

Following the hookwire placement, a piece of the fine wire will be protruding from the breast. This projecting wire will be taped down to the skin and the hookwire remains in the abnormality in the breast. The surgeon will remove the wire together with the abnormality at the time of the operation. Your previous imaging and the images from the Hookwire Localisation will be sent with you to the operating theatre so that the surgeon may refer to them.