Objective: Preoperative needle localization under ultrasound or stereotactic guidance is an integral part of breast cancer surgery. Procedure related complications are rare, and migration of the localization wire is extremely rare. Herein, we present a case of wire migration from the breast to the lung apex in a 49-year-old woman, who refused the therapeutic removal of wire for one year after migration.

Case presentation: Preoperative wire localization under ultrasound was performed in a patient with a non-palpable breast cancer. The wire could not be found during lumpectomy and it had been proven to be in thoracic cavity in recovery room. The patient refused any intervention for wire removal; accordingly, she underwent external radiation therapy following breast-conserving surgery. The computed tomography (CT) scan confirmed the fixed wire position at 3, 6, 9, and 12 months after wire migration. Despite frequent explanations about the possible late complications, she refused wire removal until one year. During this period, she was closely followed-up for the wire position via imaging. Finally, after 12 months, the patient accepted wire removal by video-assisted thoracoscopic surgery (VATS) which was performed without complication.

Conclusions: Although preoperative wire localization for occult breast lesion is effective and safe, rare complications like migration have been reported and need early intervention.