When doctors in Australia discovered a hard mass in the breast of a 36-year-old woman who was known to have genetic risk factors for cancer, they immediately performed a biopsy, fearing she had an aggressive tumor.
But tests quickly revealed it was not cancer. It was a drop of tattoo ink: The patient was heavily tattooed and some of the ink had collected in a breast gland, mimicking the appearance of a tumor, surgeons reported in a medical journal in 2022.
In a second very similar case, this time of a 50-year-old woman, described in the Journal of Medical Imaging and Radiation Oncology in June, a lump suspected of being cancerous turned out to be hardened tattoo ink.
Twenty years ago, only 16 per cent of adults in the UK had a tattoo. Today, it’s closer to 30 percent, as body art, once largely exclusive to sailors, bikers and rock stars, has become commonplace.
David Beckham shows off his tattoo collection accumulated over the years
Now everyone from English football legend David Beckham to Princess Eugenie has embraced tattooed skin.
But while the vast majority of those with tattoos experience few (if any) significant side effects, they are by no means risk-free. Well-documented adverse reactions range from photosensitivity (in which tattooed skin becomes more sensitive to sunlight, causing itching, swelling and a burning sensation) to allergic reactions, which cause similar symptoms and are often caused by certain metals used in the red ink.
At least one in ten people who get a tattoo experience skin reactions involving itching, pain, inflammation and swelling for at least three weeks after getting it, according to a study published by scientists at the University of Copenhagen, Denmark, last December. in the journal Dermatology.
More recently, an investigation by the U.S. Food and Drug Administration (FDA) found that one-third of the 75 tattoo inks they tested contained potentially harmful bacteria that can cause serious infections in some people.
More serious complications, although extremely rare, can include life-threatening liver infections such as hepatitis B and hepatitis C, as well as HIV, almost always from contaminated needles. But now another concern is emerging about tattoo ink’s possible links to certain types of cancer.
In May, a study published in The Lancet reported that adults who had even a single tattoo were 21 percent more likely to develop lymphoma, a type of blood cancer that affects more than 16,000 people a year in the United Kingdom. United.
The disease occurs when white blood cells, called lymphocytes, begin to grow uncontrollably.
Normally, in a healthy body, lymphocytes, which are part of the immune system, help fight infections. But they can become cancerous due to factors such as a weakened immune system or prolonged exposure to chemicals such as pesticides or insecticides.
They then multiply uncontrollably and damage vital organs: around 5,000 people a year die in the UK from lymphoma.
When scientists at Lund University in Sweden compared tattoo rates in 1,300 patients diagnosed with various forms of lymphoma between 2007 and 2017 with healthy adults of the same age (20 to 60 years), those with body tattoos were more likely to have lymphoma.
Perhaps surprisingly, the risk didn’t seem to increase with more tattoos: Only one or two carried the same cancer risk as multiples. The researchers said: “Tattoo ink often contains carcinogenic (cancer-causing) chemicals and we found that it is associated with an increased risk of lymphoma; more research is urgently needed.”
In June 2023, the UK Health and Safety Executive announced that it was recommending restrictions on certain hazardous substances used in tattoo ink, which contains around 200 chemicals and additives. These included chemicals known to cause cancer, genetic mutations, skin corrosion and serious eye damage.
It’s unclear exactly how tattoo ink could trigger the cancer growth process in lymphoma. And other studies have found no such connection with an increased risk of lymphoma.
But what research has shown is that the pigments used in ink can and do travel through the bloodstream to congregate in lymph nodes, the network of bean-shaped glands throughout the body that helps regulate the immune system’s response to foreign organisms.
Once there, they can clump together to form a semi-solid mass that, seen on an MRI, can look uncannily like a cancerous growth.
“When tattoo ink is metabolized by the body, it can sometimes end up building up in the lymph nodes in the neck, armpits and groin,” says Dr Jonathan Kentley, consultant dermatologist at Chelsea and Westminster Hospital in London and spokesperson for the British Skin Foundation.
‘There have been cases where patients have had their lymph nodes surgically removed because they were thought to have cancer when they did not. Instead, it was tattoo pigment. The theory is that it freezes and then calcifies, forming a lump.
When some cancers, such as breast cancer, spread through the body, they usually travel first to nearby lymph nodes, in the case of breast cancer, in the armpit.
A 2022 Cureus magazine report highlighted the case of a 36-year-old tattooed woman from Hobart, Tasmania, who underwent regular breast cancer screening because she had a genetic mutation that put her at very high risk. It was during one of those scans that doctors noticed a small, hard mass in one of her breasts.
Dr Jonathan Kentley, consultant dermatologist at Chelsea and Westminster Hospital, London
“It’s not that the pigment necessarily causes any harm, but it can lead to confusion about whether it is cancer or not, sometimes leading to patients undergoing unnecessary procedures (such as biopsies),” says Dr. Kentley.
On the other hand, other studies have suggested that certain types of skin cancer are more likely to form in tattooed areas.
In 2020, researchers at Dartmouth-Hitchcock Medical Center in New Hampshire (USA) studied 156 patients with tattoos who developed basal cell carcinoma, a type of skin cancer that affects about 75,000 people a year in the United Kingdom. .
It usually develops in areas most exposed to the sun, including the face. And although this type of skin cancer is rarely life-threatening, it can destroy surrounding facial tissue if not removed.
The study found that in patients with tattoos, cancer was 80 percent more likely to form on inked skin than on light skin, the journal Epidemiology reported, suggesting that tattoos increase the risk of developing cancer. form cancerous growths.
Other research has also found that nearly 40 percent of skin cancers that form in tattoos develop in patches of red ink, possibly because exposure to the sun’s rays activates carcinogenic compounds found in this color of ink. ink.
Meanwhile, using dark-colored inks can make it harder to detect malignant melanoma, the most dangerous type of skin cancer. Detecting dangerous moles at the earliest stage is crucial to improving the chances of survival.
Dr. Kentley warns against tattoos on areas of the body where moles are present. “Most good tattoo artists don’t tattoo over a pre-existing mole,” he says. “If we ever see cancerous moles inside a tattoo, they are usually moles that appeared after it was done. But always do your research on the tattoo artist first.
The approximately 2,000 registered tattoo artists in Britain must be licensed by a local authority: “make sure the one you choose is licensed and ask to see before and after photos of other clients first,” advises Dr Kentley.
‘Tattoos can be removed, but most people underestimate the pain, high cost and time it takes. The lasers we use are expensive, they can require five to 12 treatment sessions and the bill can run into thousands of pounds.’
The dangers of getting tattooed with your pet’s ashes
In recent years, there has been a growing demand for so-called “memorial tattoos,” in which grieving adults have the cremated ashes of their late relative or beloved pet mixed with tattoo ink and used to decorate their body. .
But is it safe? Although cremation (where temperatures exceed 1,000°C) destroys all bacteria, the risk of infection from injecting ashes into the skin remains, says consultant dermatologist Dr Jonathan Kentley.
“The ashes have to be incredibly sterile and must be stored properly so that contaminants don’t get in. They also have to be ground more finely than what comes out of the crematorium, or the body can react as if it were a foreign material.” causing a granuloma.’
It is a small, non-cancerous group of immune cells that forms a lump under the skin in response to an infection or foreign objects. Although easily treated with steroid creams, a granuloma can become painful and inflamed.
In 2014, a 48-year-old woman in the United States died from a carnivorous insect, called streptococcal necrotizing myositis, after becoming infected with a memorial tattoo on her back that contained her dog’s cremated ashes.