Clip visibility in breast cancer imaging is essential for accurate diagnosis, localization and surgical planning. After a breast biopsy, the clip marker often becomes the only lasting landmark of the original lesion. In this article, we explore how clip visibility works across different imaging modalities, why it sometimes becomes a challenge, and what radiologists and surgeons can do to maintain a reliable roadmap for treatment.
When a clip is placed during biopsy, it serves as a permanent marker for the site of the suspicious lesion. Even if the tumor shrinks after neoadjuvant therapy or becomes less distinct on imaging, the clip should remain visible enough to guide further management. Good clip visibility is important for:
For an overview of how localization fits into the wider treatment pathway, see our article on breast cancer localization.
Mammography is often the first modality used to confirm clip position after biopsy. Most clips are designed to be well seen on standard mammographic views. Digital breast tomosynthesis can further improve visualization, especially when clips are superimposed on glandular tissue.
Radiologists typically assess:
Regular documentation of these details helps surgeons understand where the clip lies within the breast and how to approach it during surgery.
On ultrasound, clip visibility depends on clip design and surrounding tissue. Some clips appear as bright reflective structures with a small acoustic shadow, while others are less conspicuous.
Key factors that influence ultrasound visibility include:
Ultrasound guided localization procedures benefit from clear clip visualization, especially when placing a magnetic seed or wire. For more on biopsy devices that integrate clip placement, read our blog on breast biopsy devices.
Magnetic resonance imaging plays an important role in high risk screening and in the evaluation of treatment response. Some clips have specific properties that allow them to be detected on MRI as small susceptibility artifacts, while others are harder to recognize.
Radiologists should be familiar with:
In cases where a lesion is only visible on MRI, clip visibility becomes crucial for any subsequent MRI guided localization. For a more detailed look at this topic, see our blog on MRI guided localization in breast cancer surgery.
Over time, clip visibility can be reduced by changes in the breast. Hematoma, fibrosis, fat necrosis or extensive treatment response may alter the local anatomy. In some cases, clips can be partially obscured or appear to move slightly relative to the expected tumor bed.
Whenever clip visualization becomes difficult, it can help to:
Before surgery, the clip usually becomes the target for a localization procedure. This can be done using wires, radioactive seeds or non radioactive magnetic seeds. The goal is to transform the static marker seen on imaging into a dynamic guidance tool during the operation.
Magnetic localization systems allow the radiologist to place a seed at or near the clip, and the surgeon to find it with directional guidance in the operating room. For a practical comparison of localization options, see seed localization versus wire guided localization.
Sirius Medical focuses on the step after clip placement. The Pintuition Marker® is a non radioactive magnetic seed that can be placed at the clip location before surgery. During the procedure, the Pintuition System® guides the surgeon to the marker through real time visual and audio feedback.
This approach helps to:
For more insights into clinical use, visit our clinical overview.
Request a demo or explore our resources to learn how Pintuition® can support your imaging and surgical teams.
Disclaimer
This article is intended for informational purposes only and should not be considered medical advice. While Sirius Medical is dedicated to improving breast cancer treatment through innovative localization technology, we do not provide medical diagnoses or treatment recommendations. If you experience any symptoms or changes in your breast health, consult a qualified healthcare professional promptly. Early medical evaluation is crucial for accurate diagnosis and effective treatment. Always seek professional guidance for concerns regarding your health.