Mammogram Markers to Get a Clearer Picture

Skin Markers Improve Evaluation and Communication

When you have your next mammogram, you may have a marker put on your skin. Mammograms often raise enough anxiety so it's helpful to understand the reasons why your technician might be putting a radio-opaque mole marker on your skin.

 

What Are Mammogram Markers?

Mammograms are black and white images that say little about the appearance of the surface of your skin. If you have a mole or other type of skin lesion on your breast, these can set off alarms when the radiologist sees it. Having any moles marked can indicate to the radiologist that there's nothing to worry about before she begins ordering additional scans and raising your anxiety in the process.

Markers may also be placed if the radiologist wishes to clarify an area of concern on your breast. Mammogram markers are simply painless tags that clarify the results of your annual breast screening.

How Skin Markers Help You

Mammogram Skin Marker
Reasons for mammogram skin markers. Photo © Pam Stephan

Markers clarify the features that show up on your mammogram. Things like scars, moles, and extra nipples (third nipples are fairly common) can be marked so that these are not mistaken for abnormalities.

Skin markers can also draw attention to areas where you have felt a lump or had breast pain or any place that you’re worried about. This way, the radiologist reading your mammogram knows where to focus most of their attention.

Other Terms for Mammogram Markers

Mammogram markers may also be called by other terms, such as:

  • Mammography Skin Markers
  • Mammography Film Markers

These are not to be confused with biopsy marker clips. Biopsy marker clips are small stainless steel markers or clips placed at your biopsy site for future reference.

Standard Shapes for Skin Markers

Mammogram Marker - Mole
Mammogram Marker - Mole. Photo © Karl Stephan

Several different companies make skin markers for mammography. These vary in color and some even sport pretty patterns or floral designs. But when it comes to function, these important radiological markers follow a standard. Different breast features are always marked by a standard system of shapes that communicate a consistent message to the radiologist.

  • Nipple: Small pellet
  • Mole: Circle
  • Scars: Broken line
  • Palpable Bumps: Triangle
  • Pain or Concern: Square

Importance of Marking Nipples

The nipple on your breast is such a prominent feature that it may seem pointless to mark it for a mammogram. For some women, it isn’t necessary to mark the nipple, but for others, a nipple may roll from an optimal position during compression. Add to that the fact that two views from different angles are taken of the breast, and it starts to make more sense.

The nipple is an important point of reference on a mammogram. Think of it like the North Star in the night sky—once you find it, you can easily locate other features. Having a consistent way to see the nipple position makes for a more accurate reading of your mammogram. It can also make it easier to correlate features that appear on mammograms and ultrasound images.

Marking Calcifications for Biopsy

If your mammogram should show a suspicious area of calcifications or micro-calcifications and a stereotactic biopsy is recommended, a skin marker can be marked with a square skin marker. This marker helps identify the area where a biopsy should be taken.

Marking calcifications ahead of time saves time during the biopsy, as the surgeon does not have to hunt for the target area. A quick image will be taken, based on the marker position, to confirm the calcifications, and tissue samples will be taken.

Safety of Mammogram Markers

You may be wondering if having extra stuff stuck to your breast will cause additional exposure to radiation. We have good news for you. Many of these markers do not use lead and do not absorb extra X-rays.

The adhesive used is very light—not even as tacky as that used for package tape, so you won’t have to flinch when removing them after your exam. When your mammogram is done, simply peel and toss these disposable skin markers.

How Markers Appear on Your Mammogram

Mammogram Marker on Film
How markers appear on a mammogram. Mole Marker over Implant, Photo © Pam Stephan

Your breast tissue appears as a negative image on a mammogram. The radiologist can see fatty tissue, dense areas, areas of surgery, implants, calcifications, and breast masses. None of these details should be obscured when your mammogram is being analyzed, so skin markers are built to appear semi-transparent on film.

The standard shapes of the markers (circle, line, triangle) will not block out important features within your breast that your doctor needs to see. The markers will appear as light lines against the darker background of breast tissue. Because the geometric shapes are distinct from naturally-occurring shapes in your breast, the markers are easy to spot.

The image here shows a detail from a mammogram that features a mole marker—the light circle—resting on breast skin over muscle and a breast implant.

Bottom Line on Mammogram Markers

Using mammogram markers can help clarify your images by either pointing out areas not to worry about, such as moles, or areas which the radiologist wishes to visualize more closely. If your radiology technician places these markers at your next visit, ask why before panicking. Being your own advocate in your care not only helps you receive the best care, but can reduce unnecessary anxiety with the procedures.

Sources:

American College of Radiology. ACR Practice Parameters for the Performance of Screening and Diagnostic Mammograms. 2013. https://www.acr.org/~/media/3484CA30845348359BAD4684779D492D.pdf

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