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Pre-operative Tomosynthesis-Guided Hookwire Needle Localisation of
Occult Breast Lesions –A Preliminary Experience
Dr. Victor Chan
MBBS (Singapore)LMCHK (Hong Kong)FRCR (UK)
Department of RadiologyQueen Mary HospitalHospital AuthorityHong Kong
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Tomosynthesis:
A Proven Technique
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Conventional Stereotactic-Guided
Procedure
X
15 degrees
X
X X
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Conventional HW method
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Conventional Technique
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Tomosynthesis-Guided Procedure
1 mm cuts
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Advantages of Tomosynthesis
Radiation DoseVisualization and detection of architectural distortionIdentifying clusters of faint micro-calcificationRuling out non-genuine lesionsReduces rate of false positive readingsFewer women come back for repeat mammogramReduces need for biopsyAccuracy – Estimation of lesion depth in proceduresMay be particularly beneficial in the dense breastOur practice in Queen Mary Hospital
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Our Experience in Tomo-Guided HW
First-year experience from April 2018 – March 2019Sample size = 16 patientsMean age = 54 years oldAge range = 41 – 70 yearsMicro-calcification cluster in 100% (mostly faintly detected)Ultrasound 100% occultMalignancy detected in 3 out of 16 patients (19% with DCIS)Technical success = 100%, no issues with yield or histopathological accuracySafety profile = Excellent
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Tomo-guided HW Localisation
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Examples
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Summary
Depth localization is more accurate
Effectiveness of procedure is improved
Change of clinical practice for best patient care
Procedure is encouraged
No adverse events
Good feedback from our surgical colleagues
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Conclusions
Tomosynthesis Hookwire Localisation Technique for Occult Lesions is:
Effective, Accurate & Safe
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Acknowledgements
Dr. Tina LamChief of Service, Consultant Radiologist, Breast Imaging TrainerDepartment of Radiology, Queen Mary Hospital, Hong Kong
Dr. Christine LoAssociate ConsultantDepartment of Radiology, Queen Mary Hospital, Hong Kong
Ms. Wong Wai CheeSenior RadiographerDepartment of Radiology, Queen Mary Hospital, Hong Kong
Breast Imaging TeamRadiologists and Radiographers
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