Permanent Indian ink tattoos for breast cancer radiotherapy: A United Kingdom study of the emotional impact on patients following radiotherapy

IF 2.5 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
S. Wickers , R.M. Taylor , G. Royle , M.N. Gaze
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引用次数: 0

Abstract

Introduction

Post-operative radiotherapy for early breast cancer is recommended for over 30,000 people every year in the United Kingdom. The majority of these patients will be advised to have radiotherapy alignment tattoos; permanent skin marks applied with Indian ink and a lancing needle, black/green/blue in colour and approximately 2 mm in diameter. The tattoos assist the therapeutic radiographers to position the patient accurately and reproducibly for each treatment fraction. The aim of this study was to investigate the emotional impact of radiotherapy tattoos on people following breast cancer radiotherapy.

Methods

An electronic questionnaire was distributed by the charitable organisation, Breast Cancer Now, to their members who had undergone radiotherapy for early breast cancer. Based on the responses to the open and closed questions, an overall impact score was assigned to each respondent, and representative quotes extracted to contextualise the themes identified. Statistical tests were performed to evaluate the relationship between overall impact scores and several variables such as age at the time of radiotherapy, skin type, and age at the time of completing the questionnaire.

Results

204 people responded to the questionnaire. 100% had permanent Indian ink tattoos during breast cancer radiotherapy. 95% could still see the midline tattoo. 22 subthemes were identified; 4 positive, 4 neutral and 14 negative. Radiotherapy tattoos served as a constant negative reminder for 27% and affected clothing choices in 14% of respondents. 11% described feelings of ‘hating’ them. 6% were assigned positive overall impact scores, 43% neutral, and 51% had negative overall impact scores. The black/green/blue ink pigment used was commonly described as unnatural; contributing strongly to the negative appearance of the tattoos.

Conclusion

Permanent Indian ink tattoos have a negative impact on emotional well-being in the months and years following radiotherapy for early breast cancer for many people. In contrast, a very small minority feel positively about the tattoos.

Implications for practice

Our findings are unlikely to be unique to this diagnostic cohort and supports the need to offer alternatives that are less-impactful to the recipient, accessible for people of all skin colours, and fit-for-purpose in terms of radiotherapy set-up. Acknowledgement of the significant negative impact and collaboration between industry, healthcare professionals and patient representatives is key to identifying and implementing suitable alternatives as standard of care.
用于乳腺癌放疗的永久性印度墨水纹身:英国一项关于放疗后对患者情绪影响的研究。
导言:在英国,每年有超过 30,000 人被建议接受早期乳腺癌术后放疗。这些患者中的大多数人都会被建议进行放疗对位纹身;纹身是用印度墨水和穿刺针在皮肤上留下的永久性标记,颜色为黑色/绿色/蓝色,直径约为 2 毫米。这些纹身有助于放射治疗技师在每次治疗时准确、准确地定位患者。本研究旨在调查放疗纹身对乳腺癌放疗患者的情绪影响:慈善组织 "现在就乳腺癌 "向接受过早期乳腺癌放疗的会员发放了一份电子问卷。根据对开放式和封闭式问题的回答,对每位受访者进行了总体影响评分,并摘录了具有代表性的引语,以确定主题的背景。我们进行了统计测试,以评估总体影响得分与几个变量之间的关系,如接受放疗时的年龄、皮肤类型和填写问卷时的年龄。100%的人在接受乳腺癌放疗时有永久性印度墨水纹身。95%的人仍能看到中线纹身。共确定了 22 个次主题:4 个积极主题、4 个中性主题和 14 个消极主题。27%的受访者认为放疗纹身是一种持续的负面提醒,14%的受访者认为放疗纹身影响了服装的选择。11%的受访者表示 "讨厌 "纹身。6%的受访者对放疗纹身的总体影响给予了积极评价,43%的受访者持中立态度,51%的受访者对放疗纹身的总体影响给予了消极评价。所使用的黑色/绿色/蓝色墨水颜料通常被描述为不自然;这是造成纹身外观消极的主要原因:结论:在早期乳腺癌放疗后的数月和数年中,永久性印度墨水纹身会对许多人的情绪产生负面影响。相比之下,极少数人对纹身持积极态度:我们的研究结果不可能是这一诊断群组所独有的,因此有必要提供对接受者影响较小、所有肤色的人都能接受、适合放疗设置的替代方案。行业、医疗保健专业人员和患者代表认识到这一重大负面影响并开展合作,是确定和实施合适的替代方法作为标准护理的关键。
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来源期刊
Radiography
Radiography RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
4.70
自引率
34.60%
发文量
169
审稿时长
63 days
期刊介绍: Radiography is an International, English language, peer-reviewed journal of diagnostic imaging and radiation therapy. Radiography is the official professional journal of the College of Radiographers and is published quarterly. Radiography aims to publish the highest quality material, both clinical and scientific, on all aspects of diagnostic imaging and radiation therapy and oncology.
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