Migration of the breast biopsy localization wire to the pulmonary hilus

Abstract

There have been very few reports of severe complications accompanied by wire localization of breast lesions, such as transsection of the wire and wire migration to the extramammary sites. This is a report of wire migration into the pulmonary hilus demanding surgical removal.

A cosmesis outcome substudy in a prospective, randomized trial comparing radioguided seed localization with standard wire localization for nonpalpable, invasive, and in situ breast carcinomas

“…Wire localization (WL) is widely used for this purpose. However, WL can be complicated by migration 17,18 and transection 19 of the wire. WL is also associated with high rates of positive margins, 20,21 resulting in high reoperation rates.…”

An Unexpected Foreign Body Causing Twinkling Artifact On Doppler Ultrasonography

“…An antecedent history is usually definitive for diagnosis when supported by the imaging findings (1-3). In the literature migration of these materials outside the breast is also reported (2,3). Presence of a metallic foreign body without history of a surgical or percutaneous intervention is very rare and described by a limited number of case reports in the literature (4) Twinkling artifact is a color Doppler ultrasound artifact which was first described by Rahmouni et al in 1996 (5).…”

Use of 125iodine seeds (ROLLIS) for intra-operative localization of nonpalpable breast lesions: analysis of the implant of 338 seeds in 284 patients

“…It should be noted that the histological evaluation of lesions and margins is a routine procedure performed by a pathologist during the surgery in order to ensure the quality of the surgical specimen. Testimonies from surgeons prove seeds were within or close to the lesions in all cases, which is not the case with the metallic wire, which may be displaced and even migrate to further areas, hampering the complete removal of the target-lesion [5][6][7][8] . The difficulty in identifying the tip of the wire by palpation during surgery is widely known, which may compromise the safety of the surgical margins and the complete excision of the lesion.…”

“…This is an important factor, since the main objective of any given procedure to locate a lesion is to facilitate a complete surgical excision in a single event, discarding new interventions. Another drawback of the metallic wire is its displacement in the preoperative period or during surgery, with reports of its migration into the pleural cavity 5 , the miocardium 6 , pulmonary hilum 7 , abdominal cavity 8 , in addition to cases of bending and rupture both before and during surgery 9,10 . Surgeons complain that the tip of the metallic wire is difficult to be felt in palpation during the operative event, impairing the complete excision of the lesion with adequate safety margins 11 .…”