Decorative image

Wire guided excision biopsy

This procedure is also called wire localisation followed by surgical biopsy. 

What is it?

A wire guided excision biopsy means putting a thin wire into the breast tissue to show a surgeon the exact area to remove. 

Your surgeon might use this if a breast x-ray (mammogram) or breast ultrasound has shown an abnormal area, but they can't feel anything when they examine you. The abnormal area might look more dense than usual or it might contain calcium specks. 

You may have this test if it’s difficult to do other tests, such as a needle or core biopsy. 

You have a wire guided biopsy in 2 stages:

  • the wire is put in place using a local anaesthetic in the radiology department or breast unit in the hospital
  • later that same day, or the following day, you have surgery with a general anaesthetic to remove the area

The wire is thin and flexible similar to fishing wire.

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

Wire guided wide local excision  

Some women might have a wire localisation once they have had a diagnosis of breast cancer, in preparation for their breast cancer surgery. The wire is placed in the cancerous area, showing the surgeon the area to remove.

You may also hear this called wire guided wide local excision or breast conserving surgery. 

Pre assessment appointment

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

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

Do ask lots of questions if you want to. 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 will have a general anaesthetic for the 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.

Placing the wire

In most hospitals, you have the wire put in place on the same day as your biopsy. Some hospitals might do this the day before.

You have this in the radiology department or breast unit in the hospital. The wire is put in place by a specialist doctor called a radiologist.

A staff member in the x-ray department will take you into a room and will ask you to take off your upper clothing.

You usually sit or lie on a couch to have this. When you are comfortable you have either a mammogram or breast ultrasound. This shows the abnormal area so the radiologist will know exactly where to place the wire.

The radiologist cleans part of your breast with an antiseptic solution. They then inject a local anaesthetic into the same area to numb the skin. This can sting a little at first, but it’s usually only for a few minutes. 

When the area is numb, the radiologist puts a thin wire with a small hook through the skin and into the area. The tip of the wire is placed in the centre of the abnormal area. The hook at the tip stops the wire from moving. 

The radiologist tapes the other end of the wire to your chest to keep it in place. As the wire is flexible it bends round and is taped flat on the chest, so you don’t have to worry about the wire moving.

Afterwards you can get dressed can move around freely with the wire securely in place.

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

During the breast biopsy

You have the excision biopsy under a general anaesthetic, this means you will be asleep. 

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 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 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.

You can usually get dressed and go home that evening. 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.

Ask your surgeon or nurse how much time you may need off work afterwards. This might depend on how physical your job is.

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.

Complications with the wire

In rare situations, the wire may move between the time it’s put in and surgery. So your surgeon may not be able to remove all the abnormal area. But this is very unusual.

Last reviewed: 
29 Sep 2020
Next review due: 
29 Sep 2023
  • Early and locally advanced breast cancer: diagnosis and treatment
    National Institute for Health and Care Excellence (NICE), June 2018

  • Early Breast Cancer: ESMO Clinical Practice Guidelines
    F Cardoso and others 
    Annals of oncology, 2019. Volume 30, Pages 1194-1220

  • Usefulness of hook wire localization biopsy under imaging guidance for nonpalpable breast lesions detected radiologically
    I Masroor and others
    International Journal of Women’s Health, 2012. Volume 4, Pages 445–449.