Based on contemporary scientific data, in several cases of breast cancer, surgical treatment is not the best option as a first step to treatment. In these cases, neoadjuvant or pre-operative systemic therapy (chemotherapy or hormone therapy) which comes before surgical treatment is the most beneficial for patients. For example, this way a patient who is candidate for mastectomy due to an initially large tumor can in the end be treated with a lumpectomy (removal of only one part of the breast) after the tumor is shrinks as a result of neoadjuvant therapy. In these cases, marking of the tumor with a special marker is a necessary prerequisite; this way, if the tumor disappears after neoadjuvant therapy, its initial position can be found and it can be treated with a final surgery.
In our practice, tumors are marked prior to neoadjuvant therapy with a special titanium tissue marker using ultrasonography guidance. We use a special device with a disposable inserting needle. The procedure is performed under local anesthesia and is perfectly safe. After the marker has been placed, its relationship to the tumor is being documented; most of the times, the position of the marker is also confirmed by means of a mammography. During final surgical treatment, the position of the marker is traced by placing a special hook wire, either before surgery with the help of the mammography or during surgery using ultrasounds. This way, precise removal of the area that used to host the tumor before the neoadjuvant therapy is guaranteed.