Kut Abdullah, Emiroglu Selman, Cabioglu Neslihan, Muslumanoglu Mahmut, Yilmaz Ravza, Bozdogan Atilla, Tukenmez Mustafa
Istanbul Provincial Directorate of Health, Istanbul Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey.
Department of General Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Medicine (Baltimore). 2025 Sep 5;104(36):e44052. doi: 10.1097/MD.0000000000044052.
In patients scheduled for breast-conserving surgery (BCS) after neoadjuvant chemotherapy, the primary mass is marked with a metallic clip. A comparative study was conducted to determine the efficacy and safety of tattoo application as an alternative to this invasive procedure.
Forty patients (clip: 20, tattoo: 20) after neoadjuvant chemotherapy, in the group marked with clips, nonpalpable patients were marked with wire, and BCS was performed; in the tattoo group, BCS was performed with the skin containing the tattoo. All statistical analyses was performed using Statistical Package for the Social Sciences version 25.0 (IBM Corp., Armonk). The study was ultimately completed with a total of 40 patients, comprising 20 patients in each group. In comparison to the standard method, the effect size of our study in reducing complications was d = 0.5, and the power was 88%. This power analysis demonstrates that the necessary number of targeted patients has been successfully reached.
There were no significant differences between the groups in terms of demographic and clinicopathological features in the 40 patients included in the study (P > .05). The radiological distance of the tumor to the skin was significantly lower in the group of patients who were marked with the tattoo technique than in the group of patients who underwent clipping (tattoo: 15.7 ± 7.4 vs clip: 20.7 ± 9.5) (P = .045). Reexcision requirement was lower in the tattoo group (35% vs 15%, P = .273). All 4 patients whose surgical margin closeness of the tumor was found to 1 to 2 mm, were in the clip group (P = .106). Complications (hematoma/ecchymosis) were observed in 6 (15%) patients in the clip group, and pain was observed in 5 (12.5%) patients. All patients with complications were included in the clip-marked group. Clip migration was observed in 3 (15%) of the patients. No complications were observed in the tattoo group.
Tattooing, which is an alternative to the method of marking the mass with metallic clips (accepted as the standard today) before neoadjuvant treatment, is an easy and inexpensive method with fewer complications.
在接受新辅助化疗后计划进行保乳手术（BCS）的患者中，主要肿块用金属夹标记。进行了一项比较研究，以确定纹身作为这种侵入性手术替代方法的有效性和安全性。
40例新辅助化疗后的患者（金属夹组：20例，纹身组：20例），在金属夹标记组中，不可触及的患者用金属丝标记，然后进行保乳手术；在纹身组中，含纹身的皮肤一同进行保乳手术。所有统计分析均使用社会科学统计软件包第25.0版（IBM公司，阿蒙克）进行。该研究最终共纳入40例患者，每组20例。与标准方法相比，本研究在减少并发症方面的效应量为d = 0.5，检验效能为88%。该效能分析表明已成功达到目标患者的必要数量。
纳入研究的40例患者在人口统计学和临床病理特征方面两组间无显著差异（P > 0.05）。采用纹身技术标记的患者组中肿瘤与皮肤的放射学距离显著低于采用金属夹标记的患者组（纹身组：15.7 ± 7.4 vs金属夹组：20.7 ± 9.5）（P = 0.045）。纹身组再次切除的需求较低（35% vs 15%，P = 0.273）。肿瘤手术切缘距离为1至2 mm的4例患者均在金属夹组（P = 0.106）。金属夹组有6例（15%）患者出现并发症（血肿/瘀斑），5例（12.5%）患者出现疼痛。所有出现并发症的患者均在金属夹标记组。3例（15%）患者观察到金属夹移位。纹身组未观察到并发症。
纹身作为新辅助治疗前用金属夹（目前被视为标准方法）标记肿块的替代方法，是一种简便且廉价、并发症较少的方法。
