Why breast imaging specialists need to ask patients about their tattoo history
Radiologists have yet another conundrum to contend with during exams: tattoo ink that may mimic lymph node abnormalities, researchers warned Friday.
Over time, ink that’s put into the skin for a tattoo can migrate to other areas of the body, Weill Cornell physicians explained in Clinical Imaging. The group presented a handful of these cases Friday in which ink appeared as abnormal high-density material in axillary lymph nodes on patients’ mammography screening exams.
Radiologists, notably breast imaging experts, must be aware of this potential pitfall as imaging results can lead to unnecessary biopsies, Elizabeth G. Lane and colleagues with the NewYork-Presbyterian-affiliated institution wrote in the study.
In fact, the authors argued, patients’ medical records should include any history of tattoos.
“The four cases described here support the inclusion of tattoo history within a patient's clinical history,” Lane and co-authors argued. “As tattoos continue to become more prevalent amongst women, our ability to observe how tattoo ink can present on radiological imaging must also be recognized.”
In one particular example, a 42-year-old woman recently diagnosed with carcinoma in the left breast showed “high-density foci” within multiple lymph nodes on the right breast. After looking over the mammogram, her findings were attributed to a large tattoo on her right shoulder.
Lane and colleagues said it remains unclear why only some women with tattoos experience pigment migration significant enough to show up during imaging exams. Further research into this phenomenon should be considered, they added.
Going forward, the group said both tattoo history and any prior procedures to remove tattoos should be included in a patient's clinical history.
“It may be useful to consider the role that tattoo size, location, age, and pigment(s) play in this presentation,” Lane and co-authors concluded. “Future studies capturing these characteristics may help to identify those who are more susceptible to significant pigment migration.”
Read the entire case series published in Clinical Imaging here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.