Guidance Systems for Breast Cancer Surgery

Author: OncoLink Team
Last Reviewed: May 23, 2019

If a suspicious lesion or mass is found in the breast, it may be surgically removed. If you cannot feel the mass (called non-palpable), either a wire or a reflector is placed in the breast mass prior to surgery. This helps the surgeon find the mass during surgery.  

What guidance systems are used?

There are two different ways to “mark” where a mass is in the breast; a wire or a reflector. These markers:

  • Are used to help your surgeon locate a non-palpable mass - one that cannot be felt from the outside of the breast.
  • The wire method is placed the day of surgery. The reflector can be placed prior to surgery.
  • Both markers are removed with the mass during surgery.
  • Knowing exactly where the lesion is in the breast can lead to a better cosmetic outcome and lessen the amount of tissue that is removed. 

How are they different?

Wires have been used for many years. A wire is exactly what it sounds like – a piece of wire goes through the breast tissue, into the mass and is left in place until surgery. The wire sticks out of the breast and needs to be taped or secured to the breast. This needs to be done the same day as surgery because of the risk of the wire moving if it is done earlier.

A reflector is a small “seed”, about the size of a grain of rice. The reflector is placed into the suspicious mass where it will remain until surgery. A radar wand is used to find the reflector, and in turn, the mass, during surgery. When the mass is removed, the reflector removed with it. 

How is it placed?

Whether you are having a wire or a reflector placed, your breast will be numbed using a local anesthetic. The medication used to numb your breast may sting, but the pain will quickly go away. You will have an imaging test, such as an mammogram or ultrasound to locate the lesion. Once the lesion is located, a needle that contains either a wire or a reflector is inserted into the lesion. The wire or seed is injected into the lesion and the needle is removed. You will then have another imaging test to confirm the placement of the wire or seed. 

The wire is long enough that it will stick out of the breast and will be taped securely down. Wires are often placed the same day as the surgery to remove the mass. You will not be able to see or feel a reflector that was placed. A reflector will be placed prior to the day of surgery.  

How is it removed?

If a wire was placed, the surgeon uses it to find the mass. The wire will be removed with the mass during surgery. 

If a reflector was used, the surgeon will use a handheld radar probe to find the reflector in the breast. This allows the surgeon to determine exactly where the mass is in the breast. Your surgeon will remove the mass and the reflector in it. Whether a wire or reflector was placed, the goal is for the entire mass to be removed with clean margins, meaning none of the mass has been left in the breast. 

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