Exploring the scientific literature on Nipple-Areola Complex medical tattooing in oncological breast reconstruction: a data-driven Scoping Review protocol

Medical tattooing of the nipple-areola complex (NAC) represents a crucial yet often overlooked component of the breast reconstruction pathway following oncological surgery. While growing interest surrounds its aesthetic outcomes, less attention has been paid to its psychosocial implications, professional roles involved—particularly nursing—and the variability of its delivery across healthcare settings. Previous reviews have addressed structural and outcome-related aspects, but significant gaps remain regarding the narrative, emotional, and professional dimensions of this intervention. This scoping review aims to systematically map the current scientific literature on NAC medical tattooing in the context of oncological breast reconstruction, with particular focus on professional roles (especially nursing), psychological and emotional outcomes, organizational and geographical variability, and technical practices. The review will be conducted in accordance with the Joanna Briggs Institute (JBI) guidelines and reported following the PRISMA-ScR 2020 checklist. Studies will be selected using the PCC (Population, Concept, Context) framework and retrieved from major databases (PubMed, Scopus, CINAHL, EMBASE) as well as grey literature sources. All study types addressing NAC medical tattooing in oncological breast reconstruction will be considered. Data extraction will include metadata, conceptual focus, and outcomes. A combination of narrative synthesis and advanced text analysis techniques—including lexicometric mapping, topic modeling, and sentiment analysis—will be used to analyze content. The review will provide an updated and comprehensive overview of the literature, identifying dominant themes, professional representations, emotional framing, and gaps in research. It aims to inform future clinical practice and research, particularly regarding the development of nurse-led, patient-centered NAC tattooing services.