Evaluation of a Simplified Technique for the Excision of Non-palpable Breast Cancer

Breast cancer is the most common malignancy and the leading cause of cancer-related mortality among women, with early detection through screening programs significantly improving survival rates and reducing mortality. Accurate localization and excision of early-stage non-palpable lesions minimize the need for re-excision, prevent unnecessary removal of breast tissue, and improve cosmetic outcomes. This study aimed to optimize the wire localization technique for the excision of non-palpable breast cancer. A total of 46 female patients referred to the breast unit at Kasr Al-Ainy, Cairo University, underwent wire localization excision, with wire insertion performed one day before surgery. Modifications to the localization process included optimized timing of wire insertion, enhanced radiology reporting with diagrams indicating wire distance, direction (clockwise orientation), and orthogonal mapping, as well as placement of a skin mark over the lesion site. In some cases, aqueous carbon suspension was used to improve intraoperative visualization. The incision was made near the skin site corresponding to the lesion, flaps were raised, and the wire was retracted within the wound, followed by dissection along its path with a cuff of normal tissue to ensure adequate margins. The re-excision rate was minimal and was all due to ductal carcinoma in situ at the margins. This study demonstrated that the simplified excision technique was safe, reproducible, and effective for the management of non-palpable breast cancers, offering a reliable and reproducible orthogonal map, which was found to help with minimizing the re-excision rate without any additional resources.