An evaluation of the accuracy of semi-permanent skin marks for breast cancer irradiation

Probst, Heidi; Dodwell, D.; Gray, Joanne; Holmes, Mike

doi:10.1016/j.radi.2005.07.001

Cited by 18 publications

(19 citation statements)

References 2 publications

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“…However, accuracy using this approach can be problematic (12) and the use of permanent tattoos is of concern to many patients (13). In addition, women with large or pendulous breasts are more difficult to position accurately and may need special immobilisation methods if accuracy is to be comparable to smaller breasted women.…”

mentioning

confidence: 99%

A systematic review of methods to immobilise breast tissue during adjuvant breast irradiation

2014

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Greater use of 3D conformal, Intensity Modulated Radiotherapy (IMRT) and external beam partial breast irradiation following local excision (LE) for breast cancer has necessitated a review of the effectiveness of immobilisation methods to stabilise breast tissue.To identify the suitability of currently available breast (rather than thorax) immobilisation techniques an appraisal of the literature was undertaken. The aim was to identify and evaluate the benefit of additional or novel immobilisation approaches (beyond the standard supine, single arm abducted and angled breast board technique adopted in most radiotherapy departments). A database search was supplemented with an individual search of key radiotherapy peer-reviewed journals, author searching, and searching of the grey literature. A total of 27 articles met the inclusion criteria.The review identified good reproducibility of the thorax using the standard supine arm-pole technique. Reproducibility with the prone technique appears inferior to supine methods (based on data from existing randomised controlled trials).Assessing the effectiveness of additional breast support devices (such as rings or thermoplastic material) is hampered by small sample sizes and a lack of randomised data for comparison.Attention to breast immobilisation is recommended, as well as agreement on how breast stability should be measured using volumetric imaging.

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mentioning

confidence: 99%

A systematic review of methods to immobilise breast tissue during adjuvant breast irradiation

2014

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“…4 The usefulness of permanent marks can also be limited by skin mobility and changes in patient shape and size over the years, and therefore can only serve as an indication at best of previous treatment fields. 3,7 Interestingly, additional comments made in the free text boxes by respondents indicated that procedures varied if the patient was planned and treated the same day, which supports the idea that with conventional imaging techniques tattoos are no longer required to reproduce treatment. Adaptive treatment and intrafractional IGRT advances are likely to reduce reliance upon permanent marks in the future; a balance needs to be maintained between the ALARA principle (i.e.…”

Section: The Psychology Of Permanent Marking and Ink-type Considerationsmentioning

confidence: 84%

“…3 Semi-permanent marks were found to have no impact on accuracy on a larger group of patients (n ¼ 321) but it is not reported if this approach has been translated into clinical practice. 7 Aims: Questions regarding the frequency and reason for refusing permanent marks, routine ink type used and alternative methods offered when patients refused tattoos were therefore included in the questionnaire, in order to seek patterns in issues arising and therefore to work towards shared solutions.…”

Section: The Psychology Of Permanent Marking and Ink-type Considerationsmentioning

confidence: 99%

“…The provision of choice in ink type may offer patients more control and improve their experience. 7 Indeed, a trial in 2016 of ultraviolet marks for breast cancer radiotherapy has reported favourable body image results in comparison with standard marks during the six months after treatment completion. 12 However, it has also been postulated that with advances in imaging and verification, the need for permanence of external marks for all patients is questionable.…”

Section: The Psychology Of Permanent Marking and Ink-type Considerationsmentioning

confidence: 99%

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A review of permanent marking for radiotherapy in the UK

et al. 2020

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“…1 Consequently, an acceptable cosmetic outcome following treatment is of importance to females in this increasing population. 2 …”

Section: Introductionmentioning

confidence: 99%

A randomized control trial evaluating fluorescent ink versus dark ink tattoos for breast radiotherapy

Landeg¹,

Kirby²,

Lee³

et al. 2016

The British Journal of Radiology

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Objective:The purpose of this UK study was to evaluate interfraction reproducibility and body image score when using ultraviolet (UV) tattoos (not visible in ambient lighting) for external references during breast/chest wall radiotherapy and compare with conventional dark ink.Methods:In this non-blinded, single-centre, parallel group, randomized control trial, patients were allocated to receive either conventional dark ink or UV ink tattoos using computer-generated random blocks. Participant assignment was not masked. Systematic (∑) and random (σ) setup errors were determined using electronic portal images. Body image questionnaires were completed at pre-treatment, 1 month and 6 months to determine the impact of tattoo type on body image. The primary end point was to determine that UV tattoo random error (σsetup) was no less accurate than with conventional dark ink tattoos, i.e. <2.8 mm.Results:46 patients were randomized to receive conventional dark or UV ink tattoos. 45 patients completed treatment (UV: n = 23, dark: n = 22). σsetup for the UV tattoo group was <2.8 mm in the u and v directions (p = 0.001 and p = 0.009, respectively). A larger proportion of patients reported improvement in body image score in the UV tattoo group compared with the dark ink group at 1 month [56% (13/23) vs 14% (3/22), respectively] and 6 months [52% (11/21) vs 38% (8/21), respectively].Conclusion:UV tattoos were associated with interfraction setup reproducibility comparable with conventional dark ink. Patients reported a more favourable change in body image score up to 6 months following treatment.Advances in knowledge:This study is the first to evaluate UV tattoo external references in a randomized control trial.

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An evaluation of the accuracy of semi-permanent skin marks for breast cancer irradiation

Cited by 18 publications

References 2 publications

A systematic review of methods to immobilise breast tissue during adjuvant breast irradiation

A systematic review of methods to immobilise breast tissue during adjuvant breast irradiation

A review of permanent marking for radiotherapy in the UK

A randomized control trial evaluating fluorescent ink versus dark ink tattoos for breast radiotherapy

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