Please wear a shirt and trousers or skirt.

Usually, this procedure will be carried out a few hours (or less) before you have surgery to remove the abnormality. There is no preparation required for the hookwire localisation.

You should bring with you to the hookwire localisation any recent mammograms, ultrasounds or MRI scans and the reports, so these can be reviewed by the radiologist before your procedure. Your surgeon will organise how this should be arranged (whether you bring them on the day or whether they are forwarded to the radiologist in advance).

A Radiographer (X-ray technician) and a Radiologist (Doctor specialising in medical Imaging) will explain the procedure to you.  After the Radiologist reviewed your images, the Radiographer will position your breast and it will be compressed. You will be in this position for a approximately 15 - 20 minutes, so let the radiographer know if the pressure is too uncomfortable.

The Radiologist will prepare the area with some liquid skin antiseptic. If you are allergic to iodine, please let us know at the start of the examination.

After local anaesthetic has been injected, a fine needle will be inserted into the breast and placed near the area that the surgeon wants to locate. X-rays from both the side and the top of the breast will be taken to check the positioning of this needle.

When the needle is correctly located, a fine wire will be released through the needle and the needle withdrawn. This piece of wire will stay in the breast to mark the area for the surgeon.

The wire has a small hook at the end and this keeps it secure. When the localisation procedure is completed the end of the wire is secured onto your breast with a dressing.  The wire will stay in place with normal movement - you shouldn't swing your arm vigorously, but otherwise with normal movement it is unlikely to change position.

Following the procedure you will head to surgery

Following the excision the area is x-rayed, and on to pathology. The results will be sent to your surgeon.

A piece of the fine wire is left sticking out from the breast. After the procedure, this piece of wire is taped down to the skin, and the hookwire remains in the abnormality in the breast. The surgeon will remove the wire together with the abnormality at the time of the operation. Your previous imaging and the images from the breast hookwire localisation will be sent with you to the operating theatre, so that the surgeon can refer to them during the surgery.

This procedure will take 30 - 40 minutes.

Hookwire localisation is a simple procedure and most women have no problems. Some problems that can occur are:

• Some women may be allergic to local anaesthetic, although this is rare.
• There are some general risks with having MRI that you need to be aware of, including having metal or devices in or on your body that may not function properly in the strong magnetic field (e.g. a pacemaker).
• Rarely, there can be an allergic reaction to the MRI contrast injection that you will need before the localisation.
• Fragments of wire are occasionally left in the breast after surgery (as the result of accidental clipping or fragmentation of the wire). These rarely cause harm, as they are made from the same material as surgical clips used routinely in many operations and seldom require removal.
• Wire dislodgement. This usually occurs because the breast is composed of fatty tissue that provides a poor grip for the hookwire. While the most usual cause of dislodgement is the nature of the breast tissue, if you are travelling to another facility for your surgery with a hookwire in position, you need to take care; that is, do not carry luggage or take public transport. Dislodgement might occasionally occur with very little movement. If dislodgement occurs, you may need to have the procedure carried out again, because the tip of the wire will no longer be situated in the tissue that needs to be removed.