Cancer Breast Cancer Treatment Tattoos for Breast Radiation Therapy These markings are done to help guide treatment By Pam Stephan Pam Stephan is a breast cancer survivor. Learn about our editorial process Pam Stephan Medically reviewed by Medically reviewed by Casey Gallagher, MD on May 23, 2019 Casey Gallagher, MD, is board-certified in dermatology. He is a clinical professor at the University of Colorado in Denver, and co-founder and practicing dermatologist at the Boulder Valley Center for Dermatology in Colorado. His research has been published in the New England Journal of Medicine. Learn about our Medical Review Board Casey Gallagher, MD Updated on October 19, 2019 Print Table of Contents View All Size and Appearance What It Feels Like Permanence Side Effects Alternatives Removal Options Before having breast radiation, you may need to have skin markings or radiation tattoos put on your breast skin. These marks help your radiation therapist aim the radiation precisely where it's needed. You may receive radiation five days a week for six weeks, and every treatment must be aimed at the same place in order to prevent recurrence and to spare healthy tissue. Verywell / Jessica Olah Size and Appearance Your breast radiation tattoos will be tiny—about the size of a freckle, or one millimeter in diameter. There will often be four tattooed dots, each marking one corner of the area to be radiated, but some radiation centers are now only doing one or two. Radiation tattoos are often in regions that won't be seen by others. They are blue or black and created using a drop of ink and a very slender needle. These tattoos won't wash off, so you will be able to shower or swim anytime during treatment without losing these important markings. Radiation tattoos will be created during your treatment simulation before actual treatments begin. What It Feels Like You may feel the needle stick, but it shouldn't hurt any more than a mosquito bite. Many women say that it hurts less than a blood draw or the insertion of an intravenous needle for chemotherapy. Permanence Most radiation tattoos will be permanent, though some radiation therapists use temporary versions. While some women may prefer a reversible method such as this, these marks have to be kept dry until the end of therapy. In other words, if temporary markers become wet, you could risk your radiation therapy being inaccurate. Side Effects There are very few side effects related to the use of tattoos for breast cancer radiotherapy. In extremely rare cases, people have had allergic reactions to the dye. Skin Problems After Radiation Alternatives Studies are in progress looking at an alternative to visible tattoos for radiation therapy. One study found that women who had invisible tattoos applied (using fluorescent dye) had improved body image six months after treatment compared to those who had conventional tattoos. Removal Options If your chances of recurrence are very low and your oncologist agrees, you may wish to consider having your tattoos removed. Options include surgery, dermabrasion, and cryotherapy. A dermatologist should be able to guide you on the best method to use. How Tattoos Are Removed A Word From Verywell Coping with radiation tattoos is easier if you understand their purpose and importance. Many women see their radiation tattoos as marks of survival and strength, rather than something they want to have removed. You may even decide to turn your tattoos into a creative design to celebrate your survival. Was this page helpful? Thanks for your feedback! Get honest information, the latest research, and support for you or a loved one with breast cancer right to your inbox. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Landeg SJ, Kirby AM, Lee SF, et al. A Randomized Control Trial Evaluating Fluorescent Ink Versus Dark Ink Tattoos for Breast Radiotherapy. Br J Radiol. 2016;89(1068):20160288. doi:10.1259/bjr.20160288 Rathod S, Munshi A, Agarwal J. Skin markings methods and guidelines: A reality in image guidance radiotherapy era. South Asian J Cancer. 2012;1(1):27-29. doi:10.4103/2278-330X.96502