Tattoo Ink May Show Up as Suspicious Spots in Lymph Nodes During Cancer Screening

Gina Pozzi‘s mother died of breast cancer at the age of 47. Now, at age 45, Gina’s annual mammogram seems to show that she’s suffering from the same disease. There’s a suspicious spot in her right breast and white specks in her armpit lymph nodes as well that resemble calcium deposits.

“When cancer hits you in the lymph nodes, it’s a game-changer,” says Gina. “That’s what happened with my mom. The cancer came back and went to her lymph nodes.”

However, Gina’s suspicious mammogram results didn’t turn out to be quite correct. She underwent biopsies of her breast and lymph node tissue, which showed she had an early-stage breast tumor but that the cancer had not yet spread to her lymph nodes as the mammogram had suggested. She had a simple lumpectomy and radiation to rid her body of the disease.

So what were the specks on her lymph nodes? They actually turned out to be ink from a tattoo on Gina’s right arm. Her immune cells had consumed some of the pigment from her skin and then brought it to her lymph nodes.

Luckily, there’s no evidence that having tattoos increases the risk of developing breast cancer. But Gina says she believes it’s important for people to know that having tattoos could cause issues with cancer screening that they should be aware of.

“I would have appreciated knowing it was a possibility that this could happen,” Gina says. “Would it have deterred me from getting tattooed? Probably not.”

There are also lots of other harmless things that cause white spots in lymph nodes. Gold injections, deodorant with aluminum, and other things can activate immune cells and carry those particles to the lymph nodes. There can also be benign calcifications caused by breast injuries or infections, fibrous cysts, or radiation therapy.

The issue with these things is that they may require more imaging and biopsies for lab analysis to rule out metastatic cancer. There’s really no other way to know whether the spots are breast cancer or something else. Women with tattoos but no family history of breast cancer or any other hint of cancer besides spots in the armpit lymph nodes, however, may opt not to have a biopsy, as it’s likely their tattoos are causing the spots.

Radiologists are no strangers to this phenomenon. “I have seen [tattoo pigment in lymph nodes] many times. I think every radiologist has,” says Susan L. Summerton, a radiologist with the University of Pennsylvania Health System. “The first case report was back in 2004. Now we probably see it a couple of times a month.”

Actually, tattoos causing issues with cancer screening was first reported as far back as 1981, when the journal Radiology published an article called “Tattoos simulating calcifications on xeroradiographs of the breast.”

It’s possible that modern tattoo inks are less likely to cause deposits in the lymph nodes, due to the fact that newer color formulations aren’t created with metals. But just because newer inks are “organic” doesn’t mean they’re totally safe, and it’s still possible they could cause deposits in the lymph nodes, among other potential health issues. The FDA considers these inks to be cosmetics and therefore will only take regulatory actions if a safety problem is identified.

Now Gina hopes her story can encourage federal regulators, the tattoo industry, breast cancer activists, and social media to spread the word about the possibility for tattoos to complicate breast cancer screening. Many of these parties are currently not aware of the issue of mammograms picking up on tattoo ink, but Gina hopes to change that.

“I don’t know if it’s the responsibility of the tattoo artist or doctors or others to inform women,” she says, mentioning that mastectomy patients who undergo breast reconstruction often get tattoos to recreate the nipple area. “I don’t want to be an alarmist. I just think women should have the information.”

So bear in mind if you have tattoos or are thinking about getting one, that your ink could have an impact on your next mammogram (or even subsequent ones). There’s nothing wrong with getting tattooed, but potential side effects like this one are important to know about.

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