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Tattooing Breast Cancers Treated with Neoadjuvant Chemotherapy

¹ Department of Pathology, Institut Gustave-Roussy, rue Camille Desmoulins, 94800 Villejuif, France
² Laboratory of Pharmacy, Hôpital Paul-Brousse, 14 avenue Paul Vaillant Couturier, 94800 Villejuif, France
³ Department of Surgery, Hôpital Henri Mondor, 51 rue du Maréchal de Latttre de Tassigny, 94000 Créteil, France
⁴ Laboratory of Pharmaceutical Technology, Facultéde Médecine, 1 rue Vaubenard, 14000 Caen, France
⁵ Department of Surgery, Institut Gustave-Roussy, rue Camille Desmoulins, 94800 Villejuif, France

Correspondence: Address correspondence and reprint requests to: Marie-Christine Mathieu; E-mail: mathieu{at}igr.fr

Background: In breast carcinomas treated with neoadjuvant chemotherapy, intraoperative identification of residual tumors may be difficult. A well-tolerated, low-diffusion charcoal suspension has been designed to tattoo breast tumors. In this study, we investigated whether this tattooing technique is efficient for localizing the tumor after treatment with chemotherapy.

Methods: In a series of 109 patients with large breast tumors, a 4% or 10% charcoal suspension was injected at the time of the initial biopsy before preoperative chemotherapy.

Results: Tolerance was good. After three or four cycles of chemotherapy, 91 patients underwent conservative treatment, and the surgical specimen was examined intraoperatively. The charcoal was detected in 94% of the cases. The charcoal was seen in the nodule or at the periphery in the surgical specimen without any acute inflammatory reaction or diffusion.

Conclusions: On the basis of these results, this micronized charcoal suspension at a defined granulometry and a concentration of 10% seems to be ideal for tattooing breast carcinomas over a period of 3 months in patients in whom neoadjuvant chemotherapy is planned.

Key Words: Breast cancer • Charcoal suspension • In vivo labeling • Neoadjuvant chemotherapy