Marking of nonpalpable breast lesions using a custom carbon suspension

Purpose: To review results of carbon marking in non-palpable breast lesions using a different type of a carbon suspension containing 0.5% polyoxyethylene sorbitan monooleate (PSM).Material and Methods: Sixteen lesions of 16 patients with indeterminate or suspicious mammographic findings underwent stereotaxic carbon marking. With the aid of tracing of the carbon stains surgery was then performed.Results: Pathology revealed malignancy in 26% of the cases and the missed rate by carbon marking was 6% (1 lesion). Carbon marking is an easier application compared to hook-wire systems in localizing occult breast lesions. PSM added to a 4% carbon suspension results in a more homogeneous suspension, prevents early precipitation and eases injection. Animal studies have shown that no local or peripheral tissue reactions are elicited with either pure PSM or in a mixture with carbon.Conclusion: We recommend addition of PSM to carbon marking suspensions.