What is a ‘hookwire procedure’?

If you are going to see a Breast Surgeon to have a lesion removed, it is important for the Breast Surgeon to know the precise location of the lesion in order to remove it completely. Women’s Imaging Radiologists’ help the breast surgeon by carefully placing a hookwire in the lesion of your breast. The procedure ensures the breast surgeon can confidently remove the lesion in theatre. The procedures takes approximately 30 minutes after which you will go straight to see the breast surgeon for the removal of the lesion.

What happens on the day?

On the day of the hookwire procedure you will arrive at Women’s Imaging where you will see the Radiologist before going on to see the Breast Surgeon. The hookwire is placed under imaging guidance, which can be either ultrasound or mammography. The Radiologist along with the Breast Surgeon will determine in advance what kind of imaging you will have. It is important that you make yourself as comfortable as possible before the procedure starts as we need you to remain as still as you can whilst we accurately position the hookwire for the breast surgeon.

This is a sterile procedure. Your skin will be cleansed and some local anaesthetic will be injected into the region of the lesion, which will numb the area. A small incision is then made and a small needle will then be placed through the lesion using imaging guidance. Once the needle is in the correct position, the Radiologist then threads a fine wire with a small hook on the end through the needle into the heart of the lesion. The needle is then removed and the wire remains. The hook keeps the wire in place and stops it from moving. Some of the wire will sit outside of your breast. The Radiologist will then secure the wire in place on your skin.

If you have the wire placed under mammography you may be sitting or lying on your side. If you are having the wire placed under ultrasound you will be lying down, commonly with your arm above your head.

You will then have two mammography films taken with the wire in place before you leave the practice. The hook ensures the wire stays in place despite the breast being compressed for the mammography pictures. The Radiologist will ensure that the wire is in the correct place before you leave the practice and that it is securely taped to your skin. Only the surgeon can remove the taping. We will give you the pictures of the hookwire procedure to take with you to the surgeon. Please ensure you give these pictures to the surgeon prior to surgery.

Is the procedure painful?

We inject local anaesthetic into the site of the lesion. Whilst this may sting a little, it really reduces the discomfort of the procedure.  You may experience some bleeding at the site but this will be controlled by the Radiologist who will constantly monitor how you are feeling during the procedure.

Should I drive?

We suggest that you bring a friend or partner with you and that they drive you from our practice to the Breast Surgeon. You will likely be fasting for the surgery and may feel some restriction of arm movement because of the wire so it is best to have somebody with you on the day.

How long will it take?

The whole procedure takes approximately 30 minutes.

What happens afterwards?

After the hookwire has been inserted you will then go straight to see the Breast Surgeon. The breast surgeon will then use the hookwire as guide for the removal of the lesion.

Things you should know

  • This procedure takes about 30 minutes and will usually be on the day of surgery.
  • We suggest that a friend or partner drives you to the hospital from our rooms.
  • There is some pain but the local anaesthetic will minimise this.