Do Radiation Tattoos Matter?

I see it every single day, and have for about four years now. I see it in the mirror before I get into the shower and sometimes I turn just enough to either side so that I see others. I'd need a hand mirror to see the rest but I know they're there.

They are the pinpricks of tattoos received prior to breast radiation. They are my only tattoos. There's a possibility that people who don't know me well may think the one just to the right of the center of my chest is a freckle, and even those who do know me are probably not looking for these particular signs of cancer. But I notice them every day.

If I was a different person, maybe I'd turn these little blue-black dots into an elaborate body decoration with other permanent tattoos. I'm me, though, so instead I consider these flecks of color each day with silent acknowledgement of all the emotions they bring out. Some days, they anger me as reminders of the cancer life I'm now living, while other days they are just spots similar to so many freckles I have. There are days when seeing that prominent center-chest dot makes me want to cry. Once in a while, they remind me that I was lucky to respond so well to Taxol, Herceptin, and Perjeta that my oncology team wanted to treat me as if I was a patient with early-stage cancer - with a lumpectomy and radiation. They raise a kind of curiosity that I could still be alive, that a body can go through so much and still be beautiful and strong.

These reminders of a specific time in my life are never "just nothing" though, despite being so small. If our bodies are physical representations of how we live in this world, what we've experienced, and what we are experiencing now, then the visual cues of illness matter - the scar where my port was, the slight indentation of a lumpectomy scar, the lighter volume of one breast compared to the other, and the radiation tattoos scattered across my upper body.

The day I received half of those tattoos, the radiation oncologist thought I would be best radiated by lying on my stomach during the treatment. Because of this, I received one set of tattoos to allow me to line up properly for the machine while in that position. The very next day, though, I was called back in because the doctor had decided my positioning would be better if I was lying on my back, so I received a second set of tattoos. My change in positioning allowed better focus where it mattered and also minimized any radiation toward my lungs and other vital organs. A few extra dots are not a big price to pay for a result like that.

I thought I'd eventually forget about these tattoos, but that hasn't happened. It's because of their lingering effect on my psyche that I was interested when recent research showed that radiation tattoos may not be necessary with newer technology and a technique called surface-guided radiation therapy. Additional research, which involved a survey of 142 women, showed that 70% of the women interviewed had negative feelings associated with receiving radiation tattoos.

I can't say what I'd do now - would I insist on this new technique or would I be persuaded that the tattoos were the best choice? - but after four years of contemplating these little specks of hope and illness and pain, I do know these seemingly small reminders of what my body has been through are not, for me, nothing of consequence.