What to expect BEFORE your surgery. (preop wires/ sentinel nodes explained)

Understanding Breast Cancer Surgery Localization Techniques: Wires and Wireless Markers

Before undergoing breast cancer surgery, it’s essential to understand some of the steps your healthcare team takes to ensure the best possible outcome. One critical step is the localization of the area within the breast where the cancer or abnormal tissue is located. This is particularly important when the lump or abnormality cannot be felt by touch. Two commonly used techniques for localization are wire localization and wireless markers. Here’s what you need to know about each approach:

Wire Localization

Wire localization has been used for many years to guide surgeons during breast cancer surgery. Here is how the process works:

  • The Procedure: On the day of your surgery (or sometimes the day before), a radiologist will place a thin, flexible wire into your breast. This is done with the guidance of imaging, such as a mammogram, ultrasound, or MRI, to ensure accuracy.

  • Purpose: The wire serves as a guide for the surgeon, marking the exact location of the cancer or abnormal tissue that needs to be removed.

  • Experience: You may feel some pressure or discomfort during the placement of the wire, but local anesthesia is typically used to minimize pain.

  • During Surgery: The wire extends outside your breast and is secured with a small dressing. During surgery, your surgeon will follow the wire to the target area, allowing for precise removal of the tissue.

  • Video linked below- warning shows actual footage of wire use suring a surgery

Wireless Markers

Wireless localization is a newer, advanced technique that offers an alternative to wire localization. Here’s how it works:

  • The Procedure: A small device, often called a wireless marker or seed, is placed into the breast at the site of the abnormality. This is also done using imaging for accuracy. Unlike the wire, the marker is entirely internal.

  • Types of Wireless Markers: The most common types include radiofrequency markers or tiny radioactive seeds. These markers emit signals that guide the surgeon to the targeted area during the operation.

  • Timing: The marker can be placed days or even weeks before surgery, offering greater flexibility and convenience compared to wire localization.

  • Experience: The placement procedure is similar to wire localization and involves local anesthesia. Most patients find it to be a quick and tolerable process.

  • During Surgery: A special probe is used to detect the marker’s signal, allowing the surgeon to locate and remove the target tissue with precision.

Benefits and Considerations

  • Wire Localization: This technique is effective and widely available. However, the external wire may feel inconvenient or uncomfortable for some patients, and it requires placement on the day of surgery.

  • Wireless Markers: These offer greater comfort since there are no external components and allow for more scheduling flexibility. However, availability may vary depending on your healthcare facility.

Which Option is Right for You?

Your surgeon and radiologist will recommend the most appropriate localization technique based on your specific situation, including the size and location of the abnormality, your anatomy, and the resources available at your treatment center. Both techniques are safe and effective, and your care team will ensure you’re well-informed and comfortable throughout the process.

If you have any questions or concerns about wire localization or wireless markers, don’t hesitate to ask your healthcare team. Understanding these steps can help you feel more confident and prepared for your breast cancer surgery.

Sentinel Lymph Node Biopsy: What to Expect

In addition to removing the cancerous tissue in your breast, your surgeon may perform a sentinel lymph node biopsy to check if cancer has spread to the lymph nodes in your underarm (axilla). This procedure uses a combination of isosulfan blue dye and technetium-99 to identify the sentinel lymph nodes, which are the first nodes to which cancer cells are likely to spread.

  • The Procedure: Before your surgery, a small amount of technetium-99, a safe radioactive tracer, is injected into the area around your breast tumor. Shortly before surgery, isosulfan blue dye is also injected. Both substances travel to the sentinel lymph nodes, staining or marking them for easy identification during surgery.

  • Purpose: The goal is to locate and remove only the sentinel lymph nodes, minimizing the need for extensive lymph node removal and reducing the risk of side effects such as lymphedema (swelling in the arm).

  • During Surgery: Your surgeon will use a special probe to detect the radiation from the technetium-99 and visually identify the blue-stained nodes. These nodes will be removed and sent to a pathologist for examination.

  • Benefits: Sentinel lymph node biopsy is less invasive than traditional lymph node dissection and is highly accurate in determining whether cancer has spread.

This procedure is a critical part of staging breast cancer and planning further treatment. If you have any concerns or questions about sentinel lymph node biopsy, your healthcare team is here to provide guidance and support.