Choi Young Jin
Department of Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju 28644, South Korea.
World J Clin Cases. 2021 Sep 16;9(26):7863-7869. doi: 10.12998/wjcc.v9.i26.7863.
Due to the increasing number of diagnosed nonpalpable breast cancer cases, wire localization has been commonly performed for surgical guidance to remove nonpalpable breast lesions. This report presents a rare case of localized wire migration to a subcutaneous lesion of the upper back in a breast cancer patient undergoing breast-conserving surgery.
A 48-year-old female was scheduled for breast-conserving surgery for left breast cancer. Ultrasonography guided wire localization was performed intraoperatively by surgeon to localize the nonpalpable breast cancer. After axilla sentinel lymph node biopsy, we realized that the wire was not visualized. The wire was not found in the operation field, including the breast and axilla. Breast-conserving surgery was performed after wire re-localization. Intraoperative chest posteroanterior view revealed that the wire was located on the level of midaxillary line. Two days after the operation, a serial simple X-ray revealed that the wire was located on the subcutaneous lesion of the back. The wire tip was palpable under the skin of the upper back, and the wire was removed under local anesthesia.
Hooked wire misplacement can lead to fatal complications. Surgeons must consider the possibility of wire migration during breast cancer surgery.
由于已诊断出的不可触及性乳腺癌病例数量不断增加,金属丝定位已普遍用于手术引导,以切除不可触及的乳腺病变。本报告介绍了1例罕见病例,在接受保乳手术的乳腺癌患者中,金属丝局部迁移至上背部皮下病变处。
一名48岁女性计划接受左乳腺癌保乳手术。术中由外科医生在超声引导下进行金属丝定位,以确定不可触及的乳腺癌位置。在腋窝前哨淋巴结活检后,我们发现金属丝无法看到。在包括乳房和腋窝在内的手术区域均未找到金属丝。重新定位金属丝后进行了保乳手术。术中胸部正位片显示金属丝位于腋中线水平。术后两天,连续的简单X线检查显示金属丝位于背部皮下病变处。金属丝尖端在上背部皮肤下可触及,遂在局部麻醉下取出金属丝。
钩状金属丝误置可导致致命并发症。外科医生在乳腺癌手术期间必须考虑金属丝迁移的可能性。