Surgical Procedures: Needle Localization Partial Mastectomy

Also called: Needle localization lumpectomy, breast-sparing surgery, breast conserving therapy, BCT.

What is a Needle Localization Partial Mastectomy?

A needle localization partial mastectomy is when a breast mass is removed using radiology (imaging) tests to guide the procedure. Only the mass is removed, not the whole breast. Needle localization is used when a breast mass is found on a mammogram or ultrasound but cannot be felt by your provider. The surgeon needs a way to find the mass to remove it and does so with imaging tests.

How is this test done?

A radiologist first numbs the breast with a numbing medication. Using imaging guidance (mammogram, ultrasound or MRI), they will insert a needle into the breast. A thin, flexible wire is then threaded through the needle into the breast mass. Once the wire is in the right place, the needle is removed. The wire is left in the breast mass.

In the operating room (OR), under anesthesia (medication to help you sleep), the mass is removed along with a small area of normal breast tissue around the mass. The wire is also removed.

The borders (edges) of the tissue removed are called surgical margins. If the mass is found to be cancer, the goal is for the margins to not have any cancer cells in them. This helps lower the risk of cancer growing back in that breast (recurrence).

Will I stay overnight?

No. This is often done as outpatient or "same day" surgery.

Could I need more surgery?

The mass that is removed during surgery is sent to a lab. A pathologist will look at the mass under a microscope. If the pathology report says that cancer is seen at or close to the surgical margin (edges of the tissue removed), more surgery may be needed to have "clear margins."

What is recovery like?

Your provider will talk to you about your recovery and what to expect. Often, after 2-3 days you should be able to go back to your normal activity level. You should not lift anything heavy or exercise for about 2-3 weeks. After surgery, you could have any of the following issues, which will get better over time:

• Feeling sensitive or pain in the surgery area.
• Breast swelling.
• Bruising.
• Lump or firmness at the surgical site.

Can I prevent infections?

Getting an infection after this procedure is not common. You can help prevent an infection by:

• Taking a shower the night before surgery and washing your body with soap and water.
• Not putting the incision site in water (soaking in a tub or swimming).
• Washing your hands before and after touching the incision or changing the dressing.

What will I need at home?

• A supportive, cotton bra or sports bra to wear the days and weeks after surgery.
• An ice pack, covered with a thin towel, to be placed every so often to the surgical area in the first 24-48 hours. This can help decrease bleeding and swelling.
• Gauze pads (4x4) to place inside your bra for comfort and protection (no need to use any tape). Gauze pads can be found at your supermarket or pharmacy.
• Clean, supportive pillow(s) to put under your arm while sitting or to help with your position at night.
• You may have constipation after surgery. Over-the-counter medications, adding fiber to your diet, exercise (as simple as walking) and fluids may ease constipation. Ask your health-care team about over-the-counter medications that may work for you.

How do I care for the incision?

If you have a bandage after surgery, remove when your provider’s instructions say to do so (often within 48 hours). Once the bandage is removed, you may shower, but do not scrub the incision. To dry, carefully pat the incision with a clean towel. Do not use lotions, powders, or deodorant on or near the incision during the first 1-2 weeks, until it is fully closed.

Most surgeons use dissolvable sutures (stitches) inside your body that will go away on their own. On the outside, your surgeon may use surgical glue, paper tape called "steri-strips," or nothing at all. Both glue and steri-strips can get wet in the shower.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.

Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms.

There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.