Preoperative localization of nonpalpable breast nodules – which method to choose?

INTRODUCTION Along with the introduction of screening mammography, measurements of breast tumours detected during examination have signifi cantly decreased and about half of breast cancers in surgical practice are nonpalpable in examination [1]. Patients with such an early stage of breast cancer are qualifi ed for breast conserving therapy (BCT), which allows the breast to be preserved. However, BCT creates many challenges for a surgeon where proper marking of suspected and at the same time nonpalpable changes in the breast comes to the fore. It is crucial to excise the tumour with a proper, “histologically clean” margin of healthy tissues which minimizes the probability of breast cancer recurrence in women treated with conservative therapy. Correct preoperative localization of early breast cancer helps the surgeon to excise the whole lesion with the smallest volume of healthy gland necessary, which additionally improves the postoperative cosmetic effect. At present, the most frequently used methods of marking nonpalpable pathological changes in the breast are: wireguided localization controlled by mammography, computed tomography or magnetic resonance; intraoperative ultrasonography; and use of isotopic markers. The aim of this survey was to briefl y present the above methods and indicate the advantages and disadvantages resulting from their use.