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Mammogram Markers - Getting a Clearer Picture

Skin Markers Improve Communication, Cut Down on Extra Views and Callbacks

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Updated May 13, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

The last couple of times I went for my annual mammogram, the technician put stickers on me. These weren’t gold stars for good breast tissue though; she was using a radio-opaque mole marker to highlight a puffy mole on my breast skin. A raised bump like that could set off alarms when the radiologist sees it, but having a mammogram marker around it is like saying, “Move along, nothing to see here!” Mammogram markers are painless tags that clarify the results of your annual breast screening.

How Skin Markers Help You

Mammogram Skin Marker
Photo © Pam Stephan
Markers clarify the features that show up on your mammogram. Things like scars, moles, and nipples 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 – 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 - a small stainless steel marker or clip placed at your biopsy site, to be used for future reference.

Standard Shapes for Skin Markers

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. This 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.

Are These Markers Safe?

You may be wondering if having extra stuff stuck to your breast will cause additional exposure to radiation. I 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
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 the 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.

This picture shows a detail from a mammogram that features a mole marker - the light circle - resting on breast skin over muscle and a breast implant.

Source

Skin Marking Protocols In Digital Mammography. Gary J. Whitman, M. D. Associate Professor of Radiology and Associate Radiologist - Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center (UTMDACC), Houston, Texas. November 2005, published by The Beekley Corporation. PDF document.
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