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Background
Preoperative image-guided lesion localization is widely accepted as standard technique for patients with nonpalpable early-stage breast cancer who are eligible for breast conservation surgery (BCS). In preparation for this procedure, lesion location, size, type and configuration play important roles in preoperative localization planning. This pictorial exhibit will introduce an uncommon, yet effective, technique for image-guided localization utilizing single-step stereotactic mammographic guidance in lieu of alpha numeric grid placement. The case-based review will also include key steps and considerations during the planning stage, the procedure stage, and the postprocedure stage.

Educational Goals / Teaching Points
Provide an overview of mammogramphy-guided preoperative localization using a single step stereotactic approach. Provide step-by-step guidance for the single step wireless, stereotactic localization technique. Demonstrate benefits and pitfalls of this technique using case examples. Provide potential complications and ways to troubleshoot.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Lesion location, size, type and configuration play central roles in localization planning. Review of all pertinent imaging studies, imaging reports and pathology reports, with special attention to pre- and postbiopsy imaging and evaluation of the targeted lesions and the type and the position of the marker clips are key components of a successful stereotactic localization.

Conclusion
Single-step wireless preoperative stereotactic localization is an uncommon, yet effective, technique that can be employed for preoperative mammographic localization of ultrasound occult lesions. The benefits of stereotactic-guided wireless breast localization include targeting precision, improved patient comfort compared to traditional wire localization, and potentially shorter procedure times.