‍⚫ Tattoo-less radiotherapy is a well-received option after breast cancer surgery

‍⚫ It eliminates the need to permanently mark the body

⚫The tattoo-less approach shortens treatment time and increases comfort

For patients receiving radiation therapy as part of their breast cancer treatment plan, “tattoo-less radiotherapy” is currently an option at some New Jersey medical centers, including Rutgers Cancer Institute of New Jersey/Robert Wood Johnson University Hospital New Brunswick and Cooperman Barnabas Medical Center, an RWJ Barnabas Health facility.

Dr. Nisha Ohri, Rutgers Cancer Institute of New Jersey
Dr. Nisha Ohri, Rutgers Cancer Institute of New Jersey

What is Tattoo-less Radiotherapy?

Typically after breast cancer surgery, if a patient opts for breast conservation, which is the removal of the tumor, but preservation of the structure of the breast, then radiation is given to reduce the risk of cancer recurrence, said Dr. Nisha Ohri, Assistant Professor of Radiation Oncology at The Rutgers Cancer Institute of New Jersey.

Traditionally, whenever radiation treatment is given for the breasts, surgeons use tiny little tattoo marks. They look like little freckles but they are permanent little tattoos that are placed on the patient’s skin at the time of CT simulation, which is the CAT scan for radiation planning, Ohri said.

When they come back and ultimately start their radiation treatment, doctors use these tattoo marks to line the patient up on a daily basis. They use the tattoo marks as well as lasers that project out of the walls in the treatment room to set the patient up in the proper position every day, Ohri explained.

Tattoo-less radiation uses Surface Guided Radiation Therapy (SGRT) to eliminate those permanent tattoo marks. The external beam radiation therapy technique uses non-invasive light emitted from specialized three-dimensional camera units that track the patient’s skin surface anatomy in real-time to ensure the correct treatment position every single time, she said.

Senior woman having mammography scan at hospital with medical technician. Mammography procedure, breast cancer prevention
Getty Images/iStockphoto

What are the benefits of Tattoo-less Radiotherapy?

“The major benefit is that they don’t have these tattoos. These tattoos, though they are small, for some patients can be a constant reminder of their breast cancer diagnosis,” Ohri said.

If typical radiation therapy with permanent tattoo marks is used, Ohri said surgeons try to keep them in areas that are not typically visible when wearing everyday clothing. However, if women are wearing tops with a certain cut, the marks may very well be visible. This may cause long-term anxiety and body confidence issues for breast cancer survivors. So, the greatest benefit of tattoo-less radiotherapy is to just not have these marks at all, and not have to see them at any time.

The tattoo-less approach also enhances radiation quality and precision, shortens treatment time, increases patient comfort, and alleviates the stress and psychological impacts that could result from receiving permanent marks on the skin.

Patients so far seem to love it. It’s been a very successful strategy and so far, so good, Ohri said.


How long is the procedure?

Tattoo-less radiation is an outpatient procedure, usually given in daily 15-minute intervals over the course of three to four weeks, Ohri said. It is a painless, well-tolerated procedure, with virtually no recovery time. The only side effect may be a local skin reaction which clears up in a few weeks to a month, she said.

Close-up of an attractive young woman

Who is eligible?

Eligibility varies from place to place. Some centers don’t offer tattoo-less radiotherapy at all. Others use it for specific cases only.

But, at the Rutgers Cancer Institute of New Jersey, surgeons are using the tattoo-less approach for the majority of patients with early-stage breast cancer.

“That means they are having a lumpectomy and need radiation to the breast only,” Ohri said. Those in the early stages of breast cancer, only need treatment to the breast itself.
Patients with more advanced breast cancer disease often need treatment for the lymph nodes that surround the breast. “Right now, we are still using tattoos for those patients.

But for those with early-stage disease, we are, for the most part, going tattoo-less,” Ohri said.

For more information about tattoo-less radiotherapy, visit here.

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