What is a Hookwire Localisation?

A radiologist places a very fine wire marker into the breast to localise (or mark) a specific area of the breast, this was identified as needing further investigation on your mammogram.

Why is this necessary?

This procedure is performed prior to the surgeon removing a small abnormal area in your breast. The abnormality can be seen on your mammogram (breast x-ray), but is unable to be felt by your doctor, making it difficult to locate it for removal. The marker makes removal easier.

Pre Examination

The pre examination will take 40 to 60 minutes. Please wear a shirt and trousers, or skirt, and bring someone with you to take you to the surgical clinic or hospital, where you are likely to go straight after the localisation procedure.

Bring a suitcase of personal effects for your stay in the surgical ward. Your surgeon will indicate how long you will need to stay in the surgical unit after the surgery.

The Examination

There are two stages to this procedure: localisation and excision. We will perform the localisation in our clinic, and you will travel to the hospital for the excision, or removal, of the lump.


A mammographer and a radiologist will explain the procedure to you. You will have an initial mammography image taken of your breast. After the radiologist has seen this film, the mammographer will sit or lie you by the mammography machine. When you are in position your breast will be compressed. You will be in this position for a while, so let the mammographer know if the position or pressure is too uncomfortable.

The radiologist will prepare the area with liquid skin wash.

After local anaesthetic has been injected, a fine needle will be inserted into the breast and placed near the area that the surgeon wants to locate. X-rays from both the side and the top of the breast will be taken to check the positioning of this needle.

When the needle is correctly located, a fine wire will be threaded through the needle and the needle withdrawn. This piece of wire will stay in the breast to mark the area for the surgeon.

The wire has a small hook at the end that keeps it secure. When the localisation procedure is completed, the end of the needle is secured onto your skin with tape. You can put on your bra or, if you prefer, just wear a shirt or top. The wire will stay in place with normal movement - but you shouldn't swing your arm vigorously.