Do you have any tips or advice when looking for CLIPS that have been placed in a previous biopsy (stereo or Ultrasound)? Especially with patients who have had neoadjuvant chemo and the lesion has almost disappeared…
These can be so tricky !!
I think of them like looking for a foreign body in another part of the body. Use compound imaging to increase your odds of hitting the clip as a specular reflector.
Think of the clip as you would calcs on a mammo. Carefully work out where the clip is on the mammo using the breast mass locator I showed on the worksheet. Talk to the radiologist to establish the exact location, distance from nipple and distance from pec fascia. Then go and search that area. Like a foreign body it will be hard to see until you hit it as a specular reflection interface and then it will pop out and be easy to see. To get specular to the clip approach the breast tissue from multiple angles, you can roll the patient more, or less to change the topography of the breast tissue and sitting the lady up is another effective trick.
Don’t be afraid to use different transducers and different frequencies.
They can certainly be tricky.