What to Know About Titanium Markers During Breast Biopsy
If you’ve had a surgical biopsy on your breast (or you’re about to get one), you may know that your doctor uses a tiny titanium clip (the size of a sesame seed) to mark the spot that’s been tested for cancer. This identifies the area if you ever need further intervention. Thankfully, four out of five biopsies turn out to be negative. Negative or not, though, biopsies come with side effects, including soreness, burning, and discomfort in the months following surgery. Now, some people are wondering: Is the clip to blame?
Marking the Spot
There are a few reasons for inserting a marker during a breast biopsy, explains Laura Dominici, M.D., a breast surgical oncologist at Dana-Farber Cancer Institute in Boston. First, it makes it easy to identify the suspicious spot for later removal. “If their pathology results come back and someone needs surgery, we want to be able to reliably find that spot again,” Dr. Dominici says. Often, the area is tiny, but a clip indicates exactly the part of your breast in question.
Minimizing Later Intervention
It the spot in your breast turns out to be benign, the titanium clip serves as an indicator for future exams, to show the doctor that area has already been checked and a second biopsy on the same spot isn’t necessary. “It helps a radiologist in the future know what parts of the breast have been investigated with a biopsy before,” says Dr. Dominici. “They’re able to look at that and compare it to previous mammograms to make sure there have been no changes.”
Making Doctor Visits Easier
Say you get a breast biopsy when you’re living in New York, and the next year you move to California. Even if you change doctors or see someone without knowledge of your biopsy history, an x-ray will reveal the spot on your breast that has been examined already, minimizing the odds of healthy tissue being unnecessarily removed, says Marion Scoggins, M.D., a diagnostic radiologist at MD Anderson Cancer Center in Houston.
Not Just for Breast Cancer
Interestingly, these mini identifiers aren’t just used in breast biopsies. “We use titanium markers in all different types of surgeries,” says Dr. Dominici. For instance, titanium clips or clamps are used in some gallbladder surgeries, appendix surgeries, and even C-sections, when they may be necessary to help close up the affected area. Curiously, Dr. Domenici points out, people seem to worry most about potential harmful effects of the clips when they are related to the breast.
Potential Allergic Reaction
Despite the usefulness of these markers, there is some concern about the long-term implications of putting metal in the body, including allergic reactions. “There are a few reports of reactions to titanium surgical clips in the breast, which are larger than the markers used for imaging-guided breast biopsies,” says Dr. Scoggins. “But adverse reactions are extremely rare.” Still, if your skin is sensitive to metal, talk to your doctor. “For women with known sensitivity to nickel or titanium, non-metallic markers can be used,” she says.
Biopsy Side Effects
So if the strange sensations in your breast following a biopsy aren’t caused by the titanium clip, what triggers them? It’s likely related to your healing process, says Dr. Dominici. After a biopsy, many women get something called a hematoma, or a buildup of blood that looks like a bruise. “It’s a completely normal phenomenon,” she says. “Some women get very small amounts of bruising, and some women get very dramatic amounts, both inside and out.” It will likely go away on its own after a few weeks.
Other Biopsy Complications
You may also feel mild pain in the first two the three months following your biopsy. “You can have discomfort in the breast or you can have burning in the breast if it’s kind of pushing on a nerve,” Dr. Dominici says. “Many women equate those symptoms with the placement of the clip, but generally, they’re actually from the procedure itself.” Even a small surgery can take time to heal. Talk with your doctor about any potential side effects to expect.
Related Allergy Symptoms
While the clip may not cause an allergic reaction, other aspects of the biopsy might. “A special soap is used to clean the area before the biopsy, and people can develop rashes to that,” Dr. Dominici says. She notes that most women also wear a large bandage with adhesive on their breast for a week after surgery, which could also cause a rash and itching if your body reacts to the material. Though uncomfortable, these issues should clear up on their own.
Talk to Your Doctor
Anytime you feel like something isn’t right, you could sit around and worry about it… or you could call your doctor. Also, “contact the facility where the biopsy was performed,” Dr. Scoggins says. “The care provider can ask you about your symptoms and provide appropriate guidance.” If the clip does turn out to be the source of your symptoms, it can be removed—but odds are, you’re dealing with something else entirely.
Breast Biopsy: Agency for Healthcare Research and Quality. (2010). “Having a Breast Biopsy: A Guide for Women and Their Families.” ncbi.nlm.nih.gov/books/NBK45596/
Potential Allergic Reaction: American Academy of Allergy, Asthma & Immunology. (2020). “Possible Contact Dermatitis to Titanium: Potential Problem With Titanium Breast Marker.” aaaai.org/ask-the-expert/contact-dermatitis-titanium
Metal Allergy Case Report: International Medical Case Reports Journal. (2019.) “Adverse Reaction Regarding Titanium-Based Marker Clip: Case Report of a Potential Complication.” ncbi.nlm.nih.gov/pmc/articles/PMC6718166/
Hematoma: BreastCancer.org. (n.d.) “Hematoma (Blood Build-Up.)” breastcancer.org/treatment/side_effects/hematoma