Is titanium marker safe after biopsy?
Comments
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I have used those markers since they were first on the market and have never seen a complication or post procedure symptoms that could be attributed to them. Treatment would be significantly less precise without them. They also act as "do not disturb" signs for benign masses. If someone reads subsequent screening mammograms without prior studies they would see the marker and not call you back to have it worked up again. See below.
Breast Cancer Res Treat. 2012 Apr;132(3):881-93. doi: 10.1007/s10549-011-1847-x. Epub 2011 Nov 1.
A plea for the biopsy marker: how, why and why not clipping after breast biopsy?
Thomassin-Naggara I1, Lalonde L, David J, Darai E, Uzan S, Trop I.
Author information
Abstract
In the last decade, percutaneous breast biopsies have become a standard for the management of breast diseases. Biopsy clips allow for precise lesion localization, thus minimizing the volume of breast to be resected at the time of surgery. With the development of many imaging techniques (including mammography, sonography, and breast magnetic resonance imaging), one of the challenges of the multidisciplinary became to synthesize all informations obtained from the various imaging procedures. The use of biopsy markers after percutaneous biopsy is one of the keys for optimal patient management, helping the radiologist to deal with multiple lesions, to insure correlation across different imaging modalities and to follow-up benign lesions, helping the oncologist by marking a tumor prior to neoadjuvant chemotherapy, helping the surgeon by facilitating preoperative needle localization, to precisely mark the margins of extensive disease and to guide intraoperative tumor resection, and helping the pathologist to insure the lesion of interest has been removed and to identify the region of interest in a mastectomy specimen. We believe biopsy clip markers should be deployed after all percutaneous interventions and present in this review the arguments to support this statement. Minimal indications for clip deployment will also be detailed.
- PMID:
- 22042370
- DOI:
- 10.1007/s10549-011-1847-x
- [Indexed for MEDLINE]
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A case of allergic reaction to surgical metal clips inserted for postoperative boost irradiation in a patient undergoing breast-conserving therapy.
Tamai K, et al. Breast Cancer. 2001.Abstract
We report a case of a 28-year-old woman with right-sided breast cancer. The patient had been treated for atopic dermatitis since her infancy. She underwent breast-conserving surgery (BCS) in July 1998, and three titanium clips were placed at the margin of the excision cavity at the time of surgery. Two months after surgery, the patient exhibited a rapid exacerbation of atopic dermatitis. Various drugs were suspected to be the cause of the allergic reaction, but the results of a bi-digital O-ring test (BDORT) suggested an allergic reaction to titanium clips. In August 1999, the patient underwent a second operation to remove the titanium clips under local anesthesia. Allergy to surgical titanium clips is a rare complication, but in patients with a history of severe allergic diseases, a preoperative immunologic examination should be performed and the patient's history of metal allergy should be investigated.
PMID
11180773 [PubMed - indexed for MEDLINE]0 -
so Newbie, this is n=1 in a person with a very specific and severe medical condition that precipitated this reaction. This is not a reason for a blanket "see, they're not safe" warning. "Allergy to surgical titanium clips is a rare complication, but in patients with a history of severe allergic diseases, a preoperative immunologic examination should be performed and the patient's history of metal allergy should be investigated." Their value to radiologists is listed above by DJMammo, along with the benefit to women who don't have to go through numerous call backs over the same benign finding over and over again, or the women whose excisions are more precise.
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I am also worried. In addition to biopsy marker, the surgeon said she will also place markers during lumpectomy.
Anyone know if these markers will migrate? Will it stay where it is forever?
Please help.
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IF every thing that someone had shown an allergic reaction to there would be no penicillin, sulfa, or gold jewlry. Or many/most foods. Personally I'm allergic to sulfa (it has saved many people), mangoes (I break out - like some do with poison ivy - from any part of them or the tree they grow on. Not talking about bell peppers which some in the MidWest call 'mangoes'.) Ex-DIL is allergic to gold and cannot wear it.
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The markers used in image guided biopsies do not migrate. They are sterile, and they are made of non-reactive metals similar to joint replacements and pacemakers and all other metallic objects place for medical therapy. They are removed with the cancer. They stay in place forever in benign masses as they were designed to do. If removal becomes absolutely necessary, they can be removed using the stereotactic biopsy unit although I have never been asked to do so by a patient. One targets the marker as if it were a small mass or a group of calcifications and samples are taken until it shows up in one of those samples. Not sure if insurance will cover it unless it can be shown to be medically necessary.
I note the case report cited above. There has also been a case report of an immaculate conception, but you don't see that very often.
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I am allergic to titanium and insisted I not have the markers or clips used. I had them inserted during my biopsy and remained after my first lumpectomy. I had a horrible time with the incision healing. When the need arose for my 2nd lumpectomy, my doctor agreed with me and said she'd remove the clips/markers to get the metal out of my body. I had a heck of a time post radiation. I had blistering that took a few weeks to heal. One spot however did not. I got an infection in my breast in October causing fluid build up, fever and swelling. I had multiple treatments to remove the fluid. The area became thin and there was an existing sore that would not heal. I ended up in the hyperbaric chamber for the latter part of last year. Fast forward to June 1 of this year. I needed to go BACK in for another biopsy because the radiologist was seeing some more calcifications and wanted to biopsy it. Once again I "strongly urged" them NOT to put the metal in my breast. The radiologist asked me why I am so adamant about not having metal in my body. I explained my two hip surgeries and then went to the lumpectomies where you had taken the metal out. She said "you do realize there are metal clips in your breast?"I was pretty shocked and confused to put it mildly. I am now thinking back and wondering and am fairly certain that all my issues I had post radiation with healing.
If anyone else has had anything like this I'd appreciate hearing from you.
Oh and my last biopsy came back negative!! Yay!
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I had a Bx and clip placed in a lymph node pre surgery which came back positive so I knew I needed a ALND. My surgeon insisted on a Mx which I felt was overkill so I got a 2nd opinion and the the new surgeon agreed to do a Lx and remove a minimal amt of nodes. 8 nodes were taken and surprise, ALL 8 were neg. How can that be?? Did the clip cause the blue dye to bypass that node? It took me 7 Months to go see the first surgeon who did the Bx, and a u/s found the clip and that positive node. I had surgery to remove it. It sat there for an extra 7-9 months with a path report much more disturbing than the Bx path. On one hand that clip saved? my life, on the other did it trick me into believing I was free of Ln spread. I think it saved me.
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Hi everyone,
I had a core biopsy done in April this year and a titanium clip was placed. My biopsy site never healed yet. It has been a month and a week. I saw my doctor and she placed me on antibiotics and to reschedule an ultrasound of the left breast. The ultrasound showed that all was well and the doctor there just said to put some antibiotic ointment and wear bandaids to catch the bleeding. Because I was bleeding daily but just a very scant amount. Well. after 3 days of the ointment and bandaid, I found the clip, barbell shape was out and on the bandaid. I called the breast center and they confirmed it was the cllip.
Has this every happened to anyone? I have not healed yet the wound is still open but I wonder if that was just my body getting rid of the foreign body.
I was diagnosed with PASH and have to be rechecked in 6 months and they didn't replace the clip. But just to mention it when I had to do the next mammogram.
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I also have a titanium marker in my breast after biopsy. It's only been 2 weeks and the incision is healed over with no obvious infection, but my breast hurts constantly, and there is a hard lump in the position of the marker. I have had other small surgeries on my breasts before with no titanium and no problems healing. This time it is driving me crazy. I am aware of my breast every moment. It aches and feels like its 'pulling' or something when I move around or bend over. My breasts are fairly large and the marker is deep. I did not see where anyone mentioned a hard lump, but I am beginning to be concerned. Any suggestions?
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That hard lump is likely a hematoma, a not in frequent occurrence with a core biopsy depending upon your clotting time and any medications that delay clotting that may have been in your system at the time of the biopsy. They are not related to the presence of a marker but they do produce the symptoms you describe. Markers are sterile, chemically inert, and in my experience have never caused a problem.
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I have about 80 titanium clips in my stomach and a great big ol' titanium knee. Never causes trouble, except going through TSA screening.
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can the marker cause pain. Mines been in 10 months, and now I have a sharp but mild pain in the site.
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I had a biopsy in 2014, in which a marker was left in, and then surgery two months later to remove lump. Thank goodness it was benign, but surgeon said he couldn't find the marker, so it's still there. I can imagine this tiny little sesame seed looking metal implant floating around...!! I occasionally feel pain in that area. Could this be caused by the implant? I have a mammogram every year and so far all is good
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I also have pain in the area where marker was left inside my breast
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I occasionally still have pain where the area in question was excised and the marker was REMOVED.
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I had a breast reduction in 2010. From the very beginning my breasts were itching and burning. I called my doctor and he said perhaps scar tissue. Last Year I went for a mammogram and for the first time I looked at the x-rays and both breasts were loaded with clips which I was totally on the wear off. I made an appointment to go back to see the breast doctor and he denied putting clips in me. In fact he became very upset I would even accuse them of it which made no sense because he was the only one who ever did my Breast reduction. When I told him I looked at my mammogram and I saw that both Breasts he had several clips in them he became upset and asked me why the tech even show that to me. I hear titanium plates in my neck but I am highly allergic to nickle for I break out and I swell. When I was younger I wore a cheap necklace earrings and now my ears are split of the infections. I know those clips he put in the one that pure titanium and I asked him to remove them because it’s very hard to wear a bra for it presses on the clips which causes more burning. So yes it is rare but there are cases who are allergic. It’s been 8 years and the burning at times is sheer hell. I wished he had informed me prior to the breast reduction he was going to put those in me I would i objected to the breast reduction
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Is this still going on in 2023? I had to make an appointment with a surgeon about having the markers removed. Are they going to just tell me "sorry no can do"? I hate this! How can this be happening to so many women and they act like it's the first time it's ever been heard. I'm scarred. This pain is ruining my life.
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I am so sorry that you are going through this. I hope you can find some relief. While you are that very rare person who is affected by the biopsy marker, the reality is that it is a common procedure that most are unaffected by. It is not happening to so many women (no one had even posted on this thread for five years prior to today). This doesn’t diminish your pain but please understand that nothing comes with a 100% guarantee.
I had a life threatening side effect from port installation that occurs less than 1% of the time. It was horrendous but someone will fall into that unlucky statistical group, so I understand in that respect. I hope you find you can find someone to help you.
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