Experiences of breast cancer survivors following Nipple–Areola complex tattooing: A qualitative study

Background Body image issues in breast cancer recovery may extend into social and professional spheres, underlining the need for complementary interventions, like nipple-areola complex (NAC) tattooing. Objectives This study aims to explore the experiences of women who have undergone NAC tattooing at the ARCADE clinic in Reggio Emilia (Italy), specifically regarding motivation/expectations; perceptions of the quality of the aesthetic result and the service provided; and emotions/sensations related to the treatment experience. Design Qualitative study. Methods Data were collected between January and May 2025 through semi-structured interviews and photo-elicitation at Local Health Authority – IRCCS of Reggio Emilia, Italy. Women were selected using convenience sampling from a cohort of 62 patients who completed NAC tattooing between January 2023 and August 2024. A reflexive thematic analysis was used to analyze data, through which subthemes and themes were identified. Results The first theme, “From the mirror to active life: a newfound identity,” is expressed through three sub-themes. All the participants (N = 10) noted a shift towards a more normalized and less “mutilated” perception of their bodies (“The relationship with self-body image”). Through the concepts of femininity and body integrity, the sub-theme “Recognizing yourself” explores how NAC tattooing supports self-recognition. “Social relationships” presents how NAC tattooing eventually influences social and intimate interactions. The second theme, “The picture of health and its role in coping,” shows that NAC tattooing enabled patients to go beyond illness and loss, minimizing visual reminders and shifting the focus to a picture of health. Conclusion NAC tattooing facilitated a cognitive and emotional shift toward a renewed sense of self as a healthy, whole person. Although further studies are needed, preliminary findings suggest that the positive effect on body image may facilitate psychological recovery and social functioning in breast cancer patients.