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Napoles TM, Guerra C, Orenstein F, Luce JA, Merritt S, Burke NJ. Abstract P6-12-19: Healing art: Breast cancer survivor experiences with nipple-areola tattoo procedures during breast reconstruction. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-12-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Nipple-areola tattoos can provide restoration of a natural looking breast that more closely resembles its pre-surgical appearance while avoiding additional surgeries. To date, the majority of nipple-areola tattoo procedures are performed by healthcare providers with minimal training in tattoo procedures. Substandard results explain the high rates of dissatisfaction among women who receive nipple-areola tattoos. In response, professional tattoo artists have emerged as an alternative provider for women seeking reconstruction. However, few studies have examined expectations and experiences of women undergoing nipple-areola tattoo procedures provided by a professional tattoo artist outside of the traditional healthcare setting. Methods: In-depth interviews were conducted with a racially/ethnically diverse group of 30 women who had undergone nipple-areola tattooing in the past 0-2 years. Interviews were conducted in English, Spanish, Chinese, and Arabic, recorded, and translated and transcribed into English for analysis. A team of three researchers conducted iterative reviews of the data which included closely reading each transcript, coding, running queries of codes, and developing summary documents to highlight recurrent concepts and patterns which were shared and discussed in group meetings. Results: Interview narratives addressed the often unexpected impact nipple-areola tattooing had on body image, self-esteem, emotional well-being, and interpersonal relationships. Women described their decision-making processes as weighing concern about the needle, the pain, and uncertainty about the tattoo artist, setting for the procedure, and outcome with the opportunity to return to a more “normal” appearance without further surgeries. Women discussed how their initial preconceptions of tattoos and tattoo parlors were ameliorated by the spa-like setting and the tattoo artist's anticipation of such concerns which enhanced her ability to put them at ease and provide professional and compassionate care. Participants noted the integral role the tattoo artist played in their positive experiences, describing her as both an “artist” and “caregiver.” The manner in which she guided them through the decision-making process regarding the color, size, shape, and placement of their nipple-areola tattoo was noted as particularly significant and empowering. Conclusions: Nipple-areola tattooing is an acceptable and meaningful reconstruction process for medically underserved public hospital patients. Our results indicate that women should be informed of nipple-areola tattooing as an alternative to more invasive, surgical reconstruction options. Results also illustrate how the healthcare system can extend beyond the traditional healthcare setting to include and leverage non-clinical and non-traditional specialists to provide appropriate care and positive breast health outcomes for women. In order to increase access and legitimacy to these services, additional research is needed to understand how to bring tattoo artists “in-house” (i.e., into the medical setting) and how to incorporate tattoo artists into breast health teams.
Citation Format: Napoles TM, Guerra C, Orenstein F, Luce JA, Merritt S, Burke NJ. Healing art: Breast cancer survivor experiences with nipple-areola tattoo procedures during breast reconstruction [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-19.
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Affiliation(s)
- TM Napoles
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - C Guerra
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - F Orenstein
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - JA Luce
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - S Merritt
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
| | - NJ Burke
- University of California, San Francisco, San Francisco, CA; Avon Breast Care Program, San Francisco General Hospital (SFGH), San Francisco, CA; Department of Medicine (Hematology/Oncology), San Francisco, CA; Dragonfly Ink Studio, San Francisco, CA; Public Health, School of Social Sciences, Humanities, & Arts, University of California, Merced, Merced, CA
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Burke NJ, Orenstein F, Napoles T, Chaumette S, Luce J. Abstract P2-13-11: Assessing the impact of post-surgery areola repigmentation and 3-dimensional nipple tattoo procedures on body image and quality of life among medically underserved breast cancer survivors. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-13-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The benefits of 3D nipple tattooing include restoration of a natural looking breast as well as the avoidance of additional surgeries to create a breast that more closely resembles its pre-surgical appearance. 3D nipple tattooing forms part of completion of the physical reconstruction process, offers women opportunity for a greater sense of closure around the loss of their breast, and plays an important role in helping a woman feel "whole again" physically, sexually and emotionally. The project's aim was to evaluate the experience of 3D-nipple/areola tattooing for medically underserved women who have undergone breast reconstruction and remain without a nipple or areola.
Methods: In-depth interviews were conducted with 20 women who had undergone 3D-nipple/areola tattooing. Interviews were conducted in English and Spanish, recorded, translated and transcribed into English for analysis. Two research team members coded all interview transcripts and the research team met monthly to discuss emergent themes.
Results: Interview narratives addressed the often unexpected impact 3D nipple-tattooing had on body image, self-esteem, emotional well-being, intimacy, and inter-personal relationships. Women described their decision-making processes as weighing concern about the needle, the pain, and the uncertainty of the outcome with the opportunity for returning to a more 'normal' appearance. Women also discussed the impact of the experience on their survivorship and sexuality in positive ways.
Conclusions: 3-D nipple and/or areola tattooing is an acceptable and meaningful reconstruction process for medically underserved public hospital patients. The decision to undergo 3-D nipple and /or areola tattooing can be complex and is impacted by a women's surgical history and outcomes. The emotional response and positive impacts of the tattooing on body image and self-esteem illustrate the value of the procedure in the context of women's lives.
Citation Format: Burke NJ, Orenstein F, Napoles T, Chaumette S, Luce J. Assessing the impact of post-surgery areola repigmentation and 3-dimensional nipple tattoo procedures on body image and quality of life among medically underserved breast cancer survivors. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-13-11.
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Affiliation(s)
- NJ Burke
- University of California, San Francisco, San Francisco, CA; San Francisco General Hospital, San Francisco, CA
| | - F Orenstein
- University of California, San Francisco, San Francisco, CA; San Francisco General Hospital, San Francisco, CA
| | - T Napoles
- University of California, San Francisco, San Francisco, CA; San Francisco General Hospital, San Francisco, CA
| | - S Chaumette
- University of California, San Francisco, San Francisco, CA; San Francisco General Hospital, San Francisco, CA
| | - J Luce
- University of California, San Francisco, San Francisco, CA; San Francisco General Hospital, San Francisco, CA
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