Does radiotherapy affect tattoo fading in breast reconstruction patients?

Tattooing to reconstruct Nipple-Areola Complex after oncological breast surgery: a scoping review

“…Papers were classified by publication type (full texts or abstracts). Eight studies evaluated the satisfaction rate given by the patients, and three the aesthetic results, mostly considering appearance and symmetry [ 10 ], color match [ 23 ]; one study also evaluated the perceived usefulness of the NAC tattoo service [ 2 ]; one paper aimed to identify the risk factors for tattoo-related breast infections [ 13 ]; two studies focused on the relationship between radiotherapy and tattoo fading [ 24 , 25 ]; one study involved healthcare personnel, determining if the likelihood of discussing options for NAC tattooing differed between Registered Nurses (RNs) and non-RNs [ 26 ].…”

“…As reported in Table 1 , the overall quality of evidence is weak: most of the results were observational studies (based on medical records [ 13 ], with small samples [ 6 ], not methodologically rigorous [ 23 , 25 , 27 ]). Another limitation was found in the outcome measurement: none of the studies used validated instruments except one [ 28 ].…”

“…Di Censo et al [ 26 ] wanted to determine if the likelihood of discussing options for NAC tattooing and recommending tattoo artists differed between Registered Nurses (RN) ( N = 43) and non-RNs ( N = 25): no significant difference was found between the groups on awareness and recommendation of a tattoo artists providing a NAC tattoo. Aslam et al [ 25 ] aimed to identify if radiotherapy exposition influenced tattoo fading among 292 women after flap reconstruction in a UK medical facility: the median time of fading was 4,5 months. 70% of the people who had radiotherapy and subsequent NAC tattoos had problems retaining the tattoo pigment and required repeated tattoo sessions.…”

“…Another disadvantage of the technique is the color's natural fading process, which requires periodical tattoo sessions to maintain the aesthetic result. The role of RT in this phenomenon is currently not completely clear: according to Aslam et al, tattoo fading is a significant problem in RT patients [ 25 ], but Rider et al [ 24 ] suggest that the post-reconstruction RT exposition did not influence the aesthetic result. The fading phenomenon is often reported subjectively, although it may be quantifiable [ 29 ].…”

“…Nurses were the professionals primarily involved (N papers = 6), then medical staff (N papers = 4) and tattoo artists (N papers = 2). The figure of a clinical nurse specialist performing NAC tattooing was involved in 5 studies and worked in day-case or outpatient settings [ 17 , 23 – 25 ].…”