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Wire guided excision biopsy

Find out what a wire guided excision biopsy is, how you have it, and what happens afterwards. This procedure is also called wire localisation followed by surgical biopsy or wire guided excision biopsy.

What it is

A wire guided excision biopsy means putting a wire into the breast tissue to show a surgeon which piece to remove. This procedure is used if a breast x-ray (mammogram) or ultrasound has shown an abnormal area but the doctor can't feel a lump. The abnormal area might look more dense than usual or it might contain calcium specks.

You usually have this test under local anaesthetic in the breast clinic or x-ray department of the hospital. Later that day you have an operation to remove the abnormal area. You have this under a general anaesthetic.

A specialist doctor examines the removed tissue under a microscope. This can show whether breast changes are due to cancer or other conditions.

Pre assessment appointment

Your pre assessment appointment prepares you for your operation. You usually have it a few days before your procedure.

You meet members of your treatment team at this appointment and you can sign the consent form to agree to the operation.

Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.

You can ask more questions when you go into hospital so don’t worry if you forget to ask some.

At the hospital you might meet:

The surgeon

A member of the surgical team will tell you about:

  • the operation you are going to have
  • the benefits of having surgery
  • the possible risks
  • what to expect afterwards

The anaesthetist

The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.

The nurse

The nurse checks your:

  • general health
  • weight
  • blood pressure
  • pulse
  • temperature

They also check what help and support you have to see what you will need when you go home.

The breast care nurse

The breast care nurse can answer your questions about the procedure and give you information and support.

Preparing for your wire guided biopsy

Check your appointment letter for how to prepare. You go into hospital on the morning of the procedure.

You will have a general anaesthetic for the actual biopsy and you can’t eat for 6 hours beforehand. You might be able to have water for up to 2 hours beforehand. The hospital staff will give you instructions about this.

Tell your doctor or nurse if not eating could be a problem for you: for example, if you have diabetes.

Take your medicines as normal. But if you are taking any blood thinning medicines you might need to stop them. Your doctor or nurse will tell you when to stop.

Putting the wire in

In the clinic a staff member will ask you to take off your upper clothing, including your bra.

You sit or lie on a couch for the test. A doctor called a radiologist will do a mammogram or ultrasound of your breast, to show up the abnormal area. They clean the breast area and use a local anaesthetic injection to numb the skin. This might sting a little.

When the area is numb, the radiologist puts a thin wire through the skin and into the abnormal area. The end of the wire is in the centre of the abnormality. The surgeon then tapes the wire to your chest to keep it in place.

Some hospitals might use the ultrasound and inject tiny magnetic markers into the abnormal area, insead of using a wire.

During the breast biopsy

You have the excision biopsy under a general anaesthetic. 

Your nurse takes you to the operating theatre. The anaesthetist gives the anaesthetic through a small needle in a vein in the back of your hand. 

When you are asleep your surgeon makes a small cut in your breast. They then remove the abnormal area of breast tissue. The wire guides the surgeon to the right place. They leave behind as much healthy breast tissue as possible.

Your doctor will take out the guide wire when they have finished the biopsy.

After your wire assisted biopsy

You usually wake up in the recovery area of the operating theatre. Your nurse will take you back to your ward.

You have a paper stitch over the wound site with a waterproof dressing over the top. Your doctor or nurse will let you know how to look after the biopsy area and your dressing. You can have a shower or bath as normal because the waterproof dressing protects the area.

You can usually get dressed and go home that evening but some people might need to stay in hospital overnight.

You can take paracetamol if your breast is sore or tender. 

You might see some bruising in the area and this is normal. It will go after a week or two.

Don’t drive because you might be drowsy from the anaesthetic. Arrange for someone to come and pick you up from the hospital and take you home.

You will need to take at least a week off work and might need longer if your work is strenuous.

Getting your results

You usually see your surgeon in the clinic after about 2 weeks. They will give you the results of the biopsy. They tell you what it showed and whether you need any further tests or treatment.

Waiting for test results can be a very worrying time. You might have contact details for a specialist nurse and you can contact them for information if you need to. It can help to talk to a close friend or relative about how you feel.

You can also contact the Cancer Research UK nurses on freephone 0808 800 4040 for information and support. The lines are open from 9am to 5pm, Monday to Friday.

Possible risks

Wire guided biopsy is a very safe procedure but your nurse will tell you who to contact if you have any problems after your test. Your doctors will make sure the benefits of having a wire guided biopsy outweigh these possible risks.

Bleeding

It’s rare to have any bleeding after your biopsy. Your doctor or nurse will tell you what to do if you have any bleeding.

Swelling

Some people have swelling but this is rare. Let your doctor know if the area is swollen or very painful.

Infection

Your doctor or nurse will let you know how to look after the biopsy area, to keep it clean and dry.

Information and help