Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
Curr Probl Diagn Radiol. 2022 May-Jun;51(3):313-316. doi: 10.1067/j.cpradiol.2021.03.015. Epub 2021 Apr 22.
Historically, wire localization was the most widely utilized procedure for preoperative breast lesion localization. Occasionally a portion of the wire is retained in the breast. When recognized intraoperatively, the fragment can be removed immediately, but some cases are identified during post-surgical mammographic follow-up. There is little research detailing long-term stability of retained wire fragments, associated complications, or management options for cases requiring removal. We aimed to determine how often retained wire fragments remained stable, the frequency with which intervention was required, and methods available for fragment removal.
Following IRB approval, we conducted a retrospective review of patients with a retained wire localization fragment identified by EMR search seen at our institution between January 1990 and July 2019. Mammograms, localization images, specimen radiographs, and relevant clinical notes were reviewed. Information collected included breast tissue density, patient age, associated pathology, length of time the fragment was retained, presence and/or absence of fragment migration or other complications, and management of removed fragments.
Eighteen eligible patients were identified with 19 retained wire fragments. Fragments ranged in length from 1 mm -33 mm. Twelve wire fragments had mammograms available to evaluate stability. All twelve fragments were stable mammographically for an average of 96.9 months. Seven wire fragments had no follow-up mammograms available. Eight wire fragments were surgically excised. None were excised due to migration.
Localization wire fragments retained in the breast are at low risk for clinically significant migration and can be safely followed mammographically rather than undergoing immediate surgical excision or imaging-guided percutaneous removal.
从历史上看，金属丝定位是术前乳腺病变定位最广泛应用的程序。偶尔金属丝的一部分会残留在乳房内。术中发现时，可立即将其取出，但有些病例是在术后乳腺 X 线随访中发现的。关于残留金属丝片段的长期稳定性、相关并发症或需要取出时的处理方法的研究甚少。我们旨在确定残留金属丝片段的稳定性、需要干预的频率以及可用于去除碎片的方法。
在获得机构审查委员会批准后，我们对 1990 年 1 月至 2019 年 7 月期间在我院通过 EMR 搜索发现的带有金属丝定位残留片段的患者进行了回顾性研究。我们回顾了乳房 X 光片、定位图像、标本射线照片和相关临床记录。收集的信息包括乳房组织密度、患者年龄、相关病理学、碎片保留时间、碎片是否存在迁移或其他并发症以及切除碎片的管理。
确定了 18 名符合条件的患者，共 19 个残留的金属丝片段。片段长度从 1 毫米到 33 毫米不等。12 个金属丝片段有乳房 X 光片可用于评估稳定性。所有 12 个片段在 X 光片上的稳定性平均为 96.9 个月。7 个金属丝片段没有随访乳房 X 光片。8 个金属丝片段进行了手术切除。没有因迁移而切除。
乳房内残留的定位金属丝片段发生临床显著迁移的风险较低，可以安全地进行乳腺 X 线随访，而不是立即进行手术切除或影像学引导的经皮切除。
