The Ranfac Small Hub Breast Marking System was developed:
- Mammography films to localize lesion
- Scout films - generally, it is best to select approach which provides shortest distance through breast tissue (brings the lesion closer to the needle entrance)
- Advisable to insert localization needle parallel to the chest wall to prevent complications such as pneumothorax
- Insert needle without the wire to desired location and depth, usually beyond the lesion
- Once satisfied with location of needle tip, the wire is then placed into (after loading technique)
- When locating mark on wire disappears into the needle, hook is now disengaged from needle tip
- Caution: Do not attempt to advance or withdraw wire after hook is disengaged from needle tip
- With wire engaged at desired size, withdraw needle
- CC and 90 degree lateral views with a BB marker at skin entrance of wire
- Measure on the radiography the distance from the BB to lesion along length of the wire to determine appropriate length of stiffening cannula required
- Secure protruding wire to prevent retraction into breast
- Stiffening cannula is then supplied to the surgeon to be passed over the wire (nick may be needed in the skin at the wire entrance to allow the cannula to pass). With the cannula in place, it can be palpated by the surgeon and will prevent inadvertent bisection of the wire. The tip of the cannula will also mark the location of the lesion.
- Surgical specimen should be radiographed with the wire in situ
