Have tattoos? Read this before your next mammogram
Tattoos have been around for centuries, but how do they impact our modern approaches to screening for cancer? As more women reach the suggested age for screening mammograms, imaging specialists are learning these unique markings are also showing up in unexpected places – diagnostic images.
Ink from tattoos can leak into our bodies and show up in nearby lymph nodes. “It’s a sign your immune system is working properly,” says breast imaging radiologist Toma Omofoye, M.D.
When the immune system detects a foreign body, like tattoo ink, it sends immune cells to investigate and brings them back to the lymph nodes. Lymph nodes can be found all over your body, including in your neck, groin and arm pits.
Here’s what Omofoye wants you to know about mammograms if you have tattoos.
Tattoo ink can show up in lymph nodes at any time
While it’s more common for new tattoos to cause this reaction, Omofoye says even older tattoos can cause ink to appear in lymph nodes.
Permanent makeup or tattoos used to create realistic looking nipples after breast cancer surgery could affect your lymph nodes, too.
The closer the tattoo is to a lymph node, the more likely it is for ink to appear there. For example, a tattoo on your hip may cause ink to be found in a lymph node in your groin. Tattoos on your arm or chest may be found in the lymph nodes near your arm pit.
Once tattoo ink appears in your lymph nodes it can be there indefinitely – even if you’ve had the tattoo removed.
The more tattoos you have, the more lymph nodes may be affected
The phenomenon of tattoo ink appearing in lymph nodes is something scientists have only started studying recently, so Omofoye says there isn’t a lot of data to explain why some patients with tattoos experience this and some don’t.
However, she notes that the more tattoos you have, the more likely you are to have affected lymph nodes. “Someone who has a full sleeve tattoo on their arm has used more ink than someone with one small tattoo on their foot,” Omofoye says.
Tell your care team about your tattoos
Because ink on a diagnostic image can mimic more serious conditions, like breast cancer, Omofoye says it’s important to tell your care team as early as possible about any tattoos.
“Especially if you have a tattoo somewhere we can’t see during a mammogram, you should let us know,” Omofoye says.
This can help your care team understand the image more clearly if there are abnormal spots.
Other factors can affect mammogram results, too
Omofoye says radiologists are like detectives, interpreting clues for signs of cancer. “You can help us confirm some of those clues by letting us know if you have any conditions that may make your imaging come back abnormal,” she adds.
If you have a history of other types of cancer or autoimmune diseases, such as lupus, rheumatoid arthritis and sarcoidosis, your images may show your care team hints of those.
Piercings can also affect the quality of an image. “We recommend you remove nipple piercings before a mammogram so we can get the clearest picture possible,” Omofoye says. That’s because the machine adjusts to the density of the material it is scanning. Jewelry is much denser than skin or breast tissue, so you’ll get a higher dose if you keep piercings in.
Jewelry can also cause shadows or streaks in your image, which could lead to additional screening. And, breast cancer can occur anywhere, including the nipples, so your care team will want to get a clear picture of the entire breast to ensure there’s nothing abnormal.
Deodorant and some lotions can cause abnormal imaging as well. That’s why your care team will ask that you wait to use those until after your appointment is over. “Don’t worry about the way you smell,” Omofoye says. “An accurate image is what’s most important. You can apply deodorant right after your appointment,” she says.
An abnormal mammogram doesn’t always mean cancer
If a diagnostic imaging test comes back with pigment or anything else abnormal, your care team may call you back for additional screening.
“Usually, we want to do another screening like an MRI or ultrasound to rule out the possibility of cancer,” Omofoye says.
Additional screening can give your care team more information, but if it doesn’t, you may need a biopsy. That’s when your doctor takes a small sample of tissue from your breast to test it for cancer cells.
Once cancer is ruled out, these abnormal spots on your images will become part of your health history. “We can tie up your case with a bow and not worry about those spots on future imaging,” Omofoye says.