Annals of Surgical Oncology

, Volume 14, Issue 8, pp 2233–2238 | Cite as

Tattooing Breast Cancers Treated with Neoadjuvant Chemotherapy

  • Marie-Christine Mathieu
  • Laurence Bonhomme-Faivre
  • Roman Rouzier
  • Monique Seiller
  • Lise Barreau-Pouhaer
  • Jean-Paul Travagli



In breast carcinomas treated with neoadjuvant chemotherapy, intraoperative identification of residual tumors may be difficult. A well-tolerated, low-diffusion charcoal suspension has been designed to tattoo breast tumors. In this study, we investigated whether this tattooing technique is efficient for localizing the tumor after treatment with chemotherapy.


In a series of 109 patients with large breast tumors, a 4% or 10% charcoal suspension was injected at the time of the initial biopsy before preoperative chemotherapy.


Tolerance was good. After three or four cycles of chemotherapy, 91 patients underwent conservative treatment, and the surgical specimen was examined intraoperatively. The charcoal was detected in 94% of the cases. The charcoal was seen in the nodule or at the periphery in the surgical specimen without any acute inflammatory reaction or diffusion.


On the basis of these results, this micronized charcoal suspension at a defined granulometry and a concentration of 10% seems to be ideal for tattooing breast carcinomas over a period of 3 months in patients in whom neoadjuvant chemotherapy is planned.


Breast cancer Charcoal suspension In vivo labeling Neoadjuvant chemotherapy 



We thank Lorna Saint Ange for editing.


  1. 1.
    Mathieu MC, Rouzier R, Llombart-Cussac A, et al. The poor responsiveness of infiltrating lobular breast carcinomas to neoadjuvant chemotherapy can be explained by their biological profile. Eur J Cancer 2004; 40:342–51PubMedCrossRefGoogle Scholar
  2. 2.
    Wayne RW, Darby RE. Injection mammography. JAMA 1977; 237:2219–20PubMedCrossRefGoogle Scholar
  3. 3.
    Czarnecki DJ, Feider HK, Splittgerber GF. Toluidine blue dye as a breast localization marker. Am J Roentgenol 1989; 261–3Google Scholar
  4. 4.
    Wyshoff H, Gastelblum A, Lenaerts L. Preoperative localization of nonpalpable breast lesions using the so-called harpoon technic. J Belge Radiol 1985; 68:275–80PubMedGoogle Scholar
  5. 5.
    Svane GA. Stereotaxic techniques for preoperative marking of non palpable breast lesions. Acta Radiol Diagn 1983; 24:145–51Google Scholar
  6. 6.
    Baron LF, Baron PL, Ackerman SJ, Durden DD, Pope TL Jr. Sonographically guided clip placement facilitates localization of breast cancer after neoadjuvant chemotherapy. Am J Roentgenol 2000; 174:539–40Google Scholar
  7. 7.
    Edeiken BS, Fornage BD, Bedi DG, et al. US-guided implantation of metallic markers for permanent localization of the tumor bed in patients with breast cancer who undergo preoperative chemotherapy. Radiology 1999; 213:895–900PubMedGoogle Scholar
  8. 8.
    Dash N, Chafin SH, Johnson RR, Contractor FM. Usefulness of tissue marker clips in patients undergoing neoadjuvant chemotherapy for breast cancer. AJR Am J Roentgenol 1999; 173:911–7PubMedGoogle Scholar
  9. 9.
    Park I, Genta RS, Romeo DP, Weesner RE. Colonic abscess and focal peritonitis secondary to india ink tattoing of the colon. Gastrointest Endosc 1991; 37:68–70PubMedGoogle Scholar
  10. 10.
    Coman E, Brandt LJ, Breener S, Franck M, Sabbay B, Benett B. Fat necrosis and inflammatory pseudotumor due to endoscopic tattoing of the colon with india ink. Gastrointest Endosc 1991; 37:65–8PubMedGoogle Scholar
  11. 11.
    Svane G. A stereotaxic technique for preoperative marking of non palpable breast lesions. Acta Radiol Diagn 1983; 24:145–51Google Scholar
  12. 12.
    Bonhomme L, Mathieu MC, Gosse C, et al. Charcoal tattoing of mammary carcinoma in mice. Int J Pharm 1992; 80:271–5CrossRefGoogle Scholar
  13. 13.
    Mathieu MC, Bonhomme-Faivre L, Travagli JP, Seiller M, Contesso G. Presurgery labelling of breast tumours with a charcoal suspension for intratumour injection. J Oncol Pharm Practice 2001; 4:173–6CrossRefGoogle Scholar
  14. 14.
    Naveau S, Bonhomme L, Preaux N, Chaput JC. A pure charcoal suspension for colonoscopic tattoo. Gastrointest Endosc 1991; 37:624–5PubMedCrossRefGoogle Scholar
  15. 15.
    US Pharmacopeia. 22nd rev ed. Easton, PA: Mack Publishing, 1991:1483–7Google Scholar
  16. 16.
    US Pharmacopeia. 22nd rev ed. Easton, PA: Mack Publishing, 1991:1493–5Google Scholar
  17. 17.
    Bonhomme-Faivre L, Mathieu MC, Grossiord JL, et al. Formulation of a charcoal suspension for intratumor injection. Part 1. Study of the nature, granulometry, and concentration. Pharm Res 1997; 14:218–23PubMedCrossRefGoogle Scholar
  18. 18.
    Bonhomme-Faivre L, Mathieu MC, Depraetere P, Grossiord JL, Seiller M. Formulation of a charcoal suspension for intratumoral injection: influence of the pluronic F68 concentration. Int J Pharm 1997; 152:251–5CrossRefGoogle Scholar
  19. 19.
    Bonhomme L, Mathieu MC, Seiller M, Bretou M, Fredj G, Alarcon J. Charcoal labeling of mammary tumors in mice prior to chemotherapy and surgery. Eur J Pharm Sci 1993; 1:103–8CrossRefGoogle Scholar
  20. 20.
    Bonhomme-Faivre L, Mathieu MC, Orbach-Arbouys S, Seiller M. Studies on toxicity of charcoal used in tattooing of tumors. Eur J Pharm Sci 1996; 4:95–100CrossRefGoogle Scholar
  21. 21.
    Schwartz GF, Hortobagyi GN, Masood S, Palazzo J, Holland R, Page D. Consensus Conference Committee proceedings of the consensus conference on neoadjuvant chemotherapy in carcinoma of the breast, April 26–28, 2003, Philadelphia, PA. Hum Pathol 2004; 35:781–4PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2007

Authors and Affiliations

  • Marie-Christine Mathieu
    • 1
  • Laurence Bonhomme-Faivre
    • 2
  • Roman Rouzier
    • 3
  • Monique Seiller
    • 4
  • Lise Barreau-Pouhaer
    • 5
  • Jean-Paul Travagli
    • 5
  1. 1.Department of Pathology Institut Gustave-RoussyVillejuifFrance
  2. 2.Laboratory of PharmacyHôpital Paul-BrousseVillejuifFrance
  3. 3.Department of SurgeryHôpital Henri MondorCréteilFrance
  4. 4.Laboratory of Pharmaceutical TechnologyFaculté de MédecineCaenFrance
  5. 5.Department of SurgeryInstitut Gustave-RoussyVillejuifFrance

Personalised recommendations