The use of carbon suspension as an adjunct to wire localisation of impalpable breast lesions.

Aim: To determine the accuracy and therapeutic success of localisation of impalpable breast lesions by hookwire with additional lesion marking with carbon suspension to mark screen detected abnormalities requiring surgical excision.

Materials And Methods: Retrospective review of all breast localisation procedures performed in our unit on women with a screen detected abnormality requiring excision over a 7 year period.

Results: One hundred and thirty eight women underwent breast localisation procedures. All of the mammographic abnormalities were excised at the initial surgical procedure. The benign to malignant ratio was 1:2. Pre-operative cytology was used to guide the extent of surgical excision, with clear margins in 70 of the 92 patients (75 percent) with malignancy. Twenty patients had further surgery: mastectomy in 7 and further local excision in 14. The localisation procedure was a therapeutic success in the local excision of malignancy in 73 of the 92 patients (79 percent) with malignancy.

Conclusion: This method of localisation biopsy is an accurate technique for surgical excision of mammographically detected impalpable abnormalities. The surgeon is able to choose the site of surgical incision to give the best cosmetic result, the lesion is easier to identify at operation and the confidence that the abnormality has been excised is improved.