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Computed tomography-guided localization of breast lesions

      Magnetic resonance (MR) imaging and computed tomography (CT) of the breast allow the detection of breast lesion occult on physical examination, mammography, and ultrasound. We report our experience to localize such lesions under CT guidance. Thirty patients underwent 30 CT-guided preoperative localizations of breast lesions using a sequential technique or a continuous imaging. All these lesions were initially detected by MR (n=11) and/or CT (n=19) and were occult for all the other techniques. In eight patients with a superficial and/or internal lesion, a skin location using a painting pen was performed. In the 23 other cases, the extremity of a hookwire was placed into the lesion or within 5 mm surrounding the target. All the lesions were localized with success under CT guidance. The pathological analysis of the surgical specimens concluded in 11 breast cancers, four lesions of uncertain malignancy potential, and 15 benign lesions. The size of these lesions ranged from 4 to 28 mm (mean, 10 mm). No significant complication related to the procedure was observed. Localization under CT guidance is a safe and effective technique to guide the surgical biopsy of breast lesions that can be seen solely on MR or CT.
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