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Sonographically Guided Marker Placement for Confirmation of Removal of Mammographically Occult Lesions After Localization

Cecilia L. Mercado1, Amber A. Guth2, Hildegard K. Toth1, Linda Moy1, Deborah Axelrod2 and Joan Cangiarella3

1 Department of Radiology, New York University School of Medicine, New York University Cancer Institute, 160 E 34th St., 3rd Fl., New York, NY 10016.
2 Department of Surgery, New York University School of Medicine, New York, NY.
3 Department of Pathology, New York University School of Medicine, New York, NY.


Figure 1
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  		Fig. 1A —46-year-old woman without symptoms. Sonogram of left breast shows oval hypoechoic solid mass with circumscribed margins and without posterior acoustic enhancement or shadowing. Cytologic examination of specimen from sonographically guided fine-needle aspiration revealed atypical cells.

 

Figure 2
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  		Fig. 1B —46-year-old woman without symptoms. Sonogram of left breast obtained during needle localization procedure shows localization wire (arrows) coursing through lesion.

 

Figure 3
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  		Fig. 1C —46-year-old woman without symptoms. Sonogram of left breast obtained during placement of localizing marker shows collagen plug with embedded marker (arrow) visible as linear structure of increased echogenicity within lesion.

 

Figure 4
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  		Fig. 1D —46-year-old woman without symptoms. Left mediolateral oblique mammogram obtained after sonographically guided needle localization and marker placement procedures shows localizing marker (arrow) adjacent to localizing wire. Mass is mammographically occult and not visible. Retroglandular saline implant is evident.

 

Figure 5
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  		Fig. 1E —46-year-old woman without symptoms. Specimen radiograph shows localizing marker (arrow) within specimen adjacent to localizing wire. Localized lesion is not well depicted. Marker is used to confirm surgical removal of lesion. Histopathologic finding was tubular adenoma.

 

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