Diagnostic

Radiology

Tattoos Simulating Calcifications on Xeroradiographs

of the Breast1

Robert C. Brown, M.D., Richard L. Zuehlke, M.D.,

James C. Ehrhardt, Ph.D., and Peter R. Jochimsen, M.D.

Calcificatlons in the breast parenchyma and pigments used

in tattooing the skin are indistinguishable on xeroradiographs.

INDEx TERMS: Breast, calcification (Breast, neoplastic-like condition,

0[0j.310) #{149}
Breast, tattoo #{149}
Tattoos

RadIology 138: 583-584, March 1981

S EVEN years ago, one of us (R.C.B.) observed coarse bilateral

radiopacities with a geometric configuration on xeroradi-
ographs of a woman’s breasts. Though these foci appeared to
be calcifications, examination of the patient demonstrated a rose
tattooed above and slightly medial to the nipple of each breast
(Fig. 1) and matching the location of the radiopacities (Fig. 2).
Annual xeroradiographic examinations of the breasts have
shown no change in the radiopacities.

DISCUSSION
A tattoo is produced by imbedding various chemicals in the
skin (1). Although the finished image may appear homogeneous,
the tattoo is really an irregular cluster of pigment particles in the
dermis. Metallic salts provide the coloring of the pigment in most
instances; salts of cadmium, mercury, chromium, lead, iron,
copper, cobalt, aluminum, titanium, and manganese would all
be expected to produce opacities when radiographed. We do
not know which of these was used in our patient’s tattoos.
. Fig. 1. Location of the tattoo.

REFERENCE
Department of Radiology 1. Everett MA: Abnormalities of pigmentation. [In] Demis DJ, Dobson
University of Iowa Hospitals and Clinics RL McGuire JS, ed: Clinical Dermatology. Hagerstown, Md., Harper
Iowa City, Iowa 52242 & Row, 1977, Vol 2, Unit 1 1-21, pp 1-4

(Note: Fig. 2 ison page 584)

1 From the Departments of Radiology (R.C.B., J.C.E.), Dermatology (R.L.Z.), and Surgery (P.R.J.), University of Iowa Hospitals and Clinics,
Iowa City, Iowa. Received April 10, 1980 and accepted August 13. sjh

583
584 ROBERT C. BROWN AND OTHERS March 1981

Fig. 2. a. Medial and lateral projection of the breast. The dark spots
above the nipple occupy the same location as the tattoo in Figure 1. Fig. 2. b. Magnification of the upper portion of Figure 2, a.