A Bregnhøj1, M Haedersdal. 1. Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark.
Abstract
BACKGROUND: Ink markers are tattooed as landmarks before radiotherapy of breast cancer with the purpose of obtaining a precise radiation field. The black tattoo spots may cause potential psychological distress for the affected women. OBJECTIVE: The objective of this study was to evaluate the efficacy and adverse effects in a side-by-side comparison of Q-switched (Q-sw) YAG laser vs. punch biopsy excision of iatrogenic radiation tattoo markers. METHODS:Ten female volunteers with black tattoo markers after previous radiotherapy for breast cancer were included. Subjects received one punch biopsy excision and a series of three treatments at 6-week intervals with Q-sw YAG laser (Q-YAG 5 system, 1064 nm, Palomar Inc., Burlington, VT, USA); the interventions was randomly assigned to two closely located tattoos (n = 20). Treatment measures were evaluated 12 weeks after final treatment and included clinical efficacy, patient satisfaction, preferred treatment and adverse effects. A blinded observer evaluated the efficacy and adverse effects from photographs. RESULTS: Ten patients completed the study. Blinded photographic evaluations showed an overall excellent clearance (75-100% reduction in tattoo appearance) from both excision and laser treatments (P = 0.317). Patients were equally satisfied with Q-sw YAG laser treatment [median 9 (5.75-10, 25-75 percentiles)] and excision therapy [median 10 (5.75-10)] (P = 0.672). However, the majority of the patients preferred YAG laser (n = 8) to excision (n = 2) (P = 0.022) because adverse effects in terms of hypopigmentation (0/10 vs. 8/10 patients) and scarring (1/10 vs. 8/10 patients) occurred more frequently and appeared more pronounced in excision biopsy (hypopigmentation P = 0.014, scarring P = 0.021). CONCLUSION:Q-sw YAG laser and punch biopsy excision are effective to clear iatrogenic radiation tattoo markers, but patients preferred the laser treatment because of less pronounced adverse effects.
RCT Entities:
BACKGROUND: Ink markers are tattooed as landmarks before radiotherapy of breast cancer with the purpose of obtaining a precise radiation field. The black tattoo spots may cause potential psychological distress for the affected women. OBJECTIVE: The objective of this study was to evaluate the efficacy and adverse effects in a side-by-side comparison of Q-switched (Q-sw) YAG laser vs. punch biopsy excision of iatrogenic radiation tattoo markers. METHODS: Ten female volunteers with black tattoo markers after previous radiotherapy for breast cancer were included. Subjects received one punch biopsy excision and a series of three treatments at 6-week intervals with Q-sw YAG laser (Q-YAG 5 system, 1064 nm, Palomar Inc., Burlington, VT, USA); the interventions was randomly assigned to two closely located tattoos (n = 20). Treatment measures were evaluated 12 weeks after final treatment and included clinical efficacy, patient satisfaction, preferred treatment and adverse effects. A blinded observer evaluated the efficacy and adverse effects from photographs. RESULTS: Ten patients completed the study. Blinded photographic evaluations showed an overall excellent clearance (75-100% reduction in tattoo appearance) from both excision and laser treatments (P = 0.317). Patients were equally satisfied with Q-sw YAG laser treatment [median 9 (5.75-10, 25-75 percentiles)] and excision therapy [median 10 (5.75-10)] (P = 0.672). However, the majority of the patients preferred YAG laser (n = 8) to excision (n = 2) (P = 0.022) because adverse effects in terms of hypopigmentation (0/10 vs. 8/10 patients) and scarring (1/10 vs. 8/10 patients) occurred more frequently and appeared more pronounced in excision biopsy (hypopigmentation P = 0.014, scarring P = 0.021). CONCLUSION: Q-sw YAG laser and punch biopsy excision are effective to clear iatrogenic radiation tattoo markers, but patients preferred the laser treatment because of less pronounced adverse effects.
Authors: Steven J Landeg; Anna M Kirby; Steven F Lee; Freddie Bartlett; Kumud Titmarsh; Ellen Donovan; Clare L Griffin; Lone Gothard; Imogen Locke; Helen A McNair Journal: Br J Radiol Date: 2016-10-06 Impact factor: 3.039
Authors: Anthony M Rossi; Brian P Hibler; Cristian Navarrete-Dechent; Mario E Lacouture Journal: J Am Acad Dermatol Date: 2020-08-08 Impact factor: 15.487