Expert: Claes-Gustaf Nordquist, M.D. - 5/3/2011

Question
I am a registered nurse and have specific questions about the Stereotactic biopsy with metal clips being used to tag specific regions where calcifications are noted.  I have a friend who had this biopsy performed going back in June 2000.  In the report it stated that a (one) metal clip was placed in the right breast outer quadrant to mark the area where the mass was located.  She later had the lumpectomy in August 2000.  When she left the hospital (same-day surgery), the hospital never went over discharge instructions or how to care for the wound and how to empty the J-P drain.  Needless to say, my friend called me (I was a visiting nurse at the time), and I assisted her with the post-operative care.  No one ever told her a metal clip was placed in the breast back in June 2000 during the Stereotactic biopsy, nor did they tell her that the clip would remain in the right breast after the lumpectomy.  In a report dated November 2009, it reveals that she has multiple metal clips under the right axillary area (which she never had any knowledge of), and she has sharp-shooting pain in the right breast on occasion since the procedure was done June 2000.  She can't receive a straight answer from her physician because he is no longer performing biopsies.  She went for a 2nd opinion and this MD is now trying to figure out why she has a clip in her breast.  She (as well as myself) are very confused as to why the clip(s) was left in and not removed when the lump(s) were removed.  I understand the clips are used as a marker for future surgery to pin-point the exact location of the lumps, but do the clips remain inside the person forever?  Should they have been removed with the lumpectomy was performed?  Is she allowed to have an MRI if warrented?  Please email back with responses.  Thanks for your time and consideration regarding this matter.
Patricia

Answer
Well I do not quite understand the situation you describe either. These clips have an important role in precisely defining the location where a biopsy was done so that a later surgical procedure - like a lumpectomy - can be done with a high degree of precision and security. But I do not understand why it was left there after that lumpectomy unless it was just forgotten there. However they are made of titanium which is the most tissue friendly metal we have so I do not see any risks involved with it except that it may disturb MRI procedures there.



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