Tattoo Pigment Migration Within the Breast and Axilla: Radiologic-Pathologic Correlation

Area of Science:

• Radiology
• Pathology
• Oncology

Background:

• Tattoo pigment migration is an uncommon finding on breast imaging.
• It can be mistaken for malignant lesions, leading to patient anxiety and further testing.
• Previous literature reports 19 cases, with this study adding three new cases.

Purpose of the Study:

• To describe the imaging characteristics of tattoo pigment migration in the breast.
• To differentiate benign pigment migration from malignant findings on mammography and ultrasound.
• To provide guidance on the management of incidental tattoo pigment findings.

Main Methods:

• Retrospective review of three cases with tattoo pigment migration.
• Analysis of mammographic and ultrasound imaging features.
• Review of histopathological findings when biopsy was performed.

Main Results:

• Pigment migration presented as high-density deposits on mammography and echogenic foci on ultrasound.
• Common deposition sites included axillary and intramammary lymph nodes.
• Histopathology confirmed granular exogenous material consistent with tattoo pigment.

Conclusions:

• Tattoo pigment migration can mimic malignant breast findings on imaging.
• Biopsy is not necessary if findings are confidently attributed to pigment and no other abnormalities are present.
• Patients can safely resume routine screening after confirmation of benign pigment migration.