The Evolution of Localization: A Surgical Perspective 

Valerie Gorman, MD, FACS​
Surgery and Medical Director of​
Surgical Services at Baylor Scott & White Medical Center​
Waxahachie, TX​

Improved technology has created  multiple new ways of localizing non-palpable breast lesions.  This activity will educate surgeons on the various options available for wireless localization.  We will educate the surgeon  on choosing which system works best for  their patient, as well as the techniques that need to be used to perform these procedures in their practice.      

Upon completion of this lecture, participants will be able to:

  1. Discuss the advantages and disadvantages of wire vs wire-free breast tumor localization for surgical guidance​

  2. Describe techniques for wire-free localization in the breast​

  3. Explain the use of wire-free localization and neoadjuvant treatment​

  4. Understand the impact of wire-free localization on oncoplastic breast surgery techniques

Release Date: 5/26/2023
CME Expiration Date: 5/26/2026


Valerie Gorman, MD, FACS

Speaker: Hologic, Agendia, Myriad​​

All of the relevant financial relationships for these faculty have been mitigated by peer review completed by peers with no relevant financial relationships to disclose. 

None of the other planners/faculty for this educational activity have a relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, or re-selling, or distributing healthcare products used by or on patients



World Class CME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

World Class CME designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


The American Society of Radiologic Technologists Credit has approved this activity as follows:

Reference No. Cat. Activity Title Start Date Expires Credit
NCZ02330019 A The Evolution of Localization: A Surgical Perspective 6/15/2023 7/1/2026 1

This activity may be available in multiple formats or from different sponsors. A self-learning activity can be completed only once per biennium


World Class CME relies on its CME faculty to provide program content that is evidence-based and free of commercial bias. Therefore, in accordance with ACCME standards, any faculty, program director, reviewer and/or provider industry relationships will be disclosed and resolved. Speakers are required to openly disclose any limitations of data or any discussion of any off-label, experimental, or investigational uses of drugs or devices in their presentations.

This activity is supported by an unrestricted educational grant from Hologic, Inc.

Instructions to Receive Credit:  After viewing the video, click on the “Take the Quiz” button and complete the post-activity quiz.  After completing the quiz, fill out the evaluation form and submit.  Your CME certificate will then be emailed to you


Special thanks to Drs. Barry Rosen and David Weintritt for the use of their slides.​

1. Cheang E, Ha R , Thornton C, Mango V. Innovations in image-guided preoperative breast lesion localization. Br J Radiol 2018 ; 91[1085] : doi:10.1259/bjr.20170740​

2. Dodd GD, Fry K, Delany W. Preoperative localization of occult carcinoma in the breast : Nealon TF, editor. , Management of the patient with cancer. Philadelphia: The British Institute of Radiology.; 1966. 183. ​

3. Frank HA, Hall FM, Steer ML . Preoperative localization of nonpalpable breast lesions demonstrated by mammography.​
N Engl J Med. 1976 Jul 29; 295(5):259-60.​

4. Hall F, Kopans D, Sadowsk N, Homer M.  Development of wire localization.  Radiology.​

5. Homer MJ. Transection of the localization hooked wire during breast biopsy.​
AJR Am J Roentgenol. 1983 Nov; 141(5):929-30.​

6. Yim JH, Barton PM, Weber B, Radford D, et al. Mammographically detected breast cancer. Benefits of stereotactic core vs. wire localization biopsy. Ann Surg. 1996;223(6):688–700. ​

7. Abrahamson PE, Dunlap LA, Amamoo MA, Schell MJ, Braeuning MP, Pisano ED. Factors predicting successful needle-localized breast biopsy. Acad Radiol. 2003;10:601–606. ​

8. Hayes MK. Update on preoperative breast localization. Radiol Clin North Am. 2017;55:591-603.​

9. McGugin C, Spivey T, Coopey S, et al. Radiofrequency identification tag localization is comparable to wire localization for non-palpable breast lesions. Breast Cancer Res Treat. 2019:1-5. ​

10. Shetty M. Presurgical Localization of Breast Abnormalities: An Overview and Analysis of 202 Cases ​
Indian Journal of Surg Oncol. 2010;1(4):278-283​

11. Rissanen T, Makarainen H, Mattila S, Karttunen A, et al. Wire localized biopsy of breast lesions. A review of 425 cases found in screening or clinical mammography.  Clinical Radiology, 1993; 47(155): 14-22​

12. Kacmarski, K,  Et.Al.,  Surgeon Re-excision Rates After BCS: A Measure Of Low-value Care JACS 228:504 Apr 2019​

  1. Polgar C, Fodor J, Major T, et al. Breast-conserving therapy with partial or whole breast irradiation: Ten-year results of the Budapest randomized trial. Radiother Oncol 2013 ; 108[2] : 197-202. ​

  2. Strnad V, Ott O, Hildebrandt G, et al. 5-year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomized, phase 3, non-inferiority trial. Lancet 2016; 387[10015] : 229-38. ​

  3. Smith G, Xu Y, Bucholz T, et al. Association between treatment with brachytherapy vs whole-breast irradiation and subsequent mastectomy, complications, and survival among older women with invasive breast cancer. JAMA 2012 ; 307[17] : 1827-37. ​

  4. Livi L, Meattini I, Marrazzo L, et al. Accelerated partial breast irradiation using intensity-modulated radiotherapy versus whole breast irradiation: 5-year survival analysis of a phase 3 randomized controlled trial. Eur J Cancer, 2015 ; 51 [4] : 451-63.​

  5. Srour MK1, Chung A1. Utilization of BioZorb implantable device in breast-conserving surgery. Breast J. 2019 Oct 8. doi: 10.1111/tbj.13657.​

  6. Hayes, MK, et al. Update on Pre-op Breast Localization. Radiologic Clinics of North America 2017; 55 (3): 591-603.​

  7. Jakub, J.W., et al. Current Status of Radioactive Seed for Localization of Non-palpable Breast Lesions. The American Journal of Surgery. 2010; 199 (4): 522-528.​

  8. Nicolai, A., et al. Evaluation of Ferromagnetic Marker Technology for Intaoperative Localization of Non-palpable Breast Lesions. American Journal of Roentgenology. 2019; 212:727-733.​

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