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DEAR MAYO CLINIC: A friend of mine announced that she did her annual mammogram last week. At the appointment, she was asked if she had been vaccinated against COVID-19 and had noticed any changes in her breasts. I recently received my first dose of a COVID-19 vaccine. Although I feel fine, I wonder if there is a link between vaccinating against COVID-19 and an increased risk of breast problems. I’m due for my mammography appointment in a few weeks.
ANSWER: Some women may experience breast cancer with lymph nodes swollen under one arm. Some patients have reported developing swollen lymph nodes after receiving a COVID-19 vaccination, and this has raised questions about whether screening mammograms should be postponed amid concerns that this finding could be confused with a possible diagnosis of breast cancer.
The Mayo Clinic’s recommendation is that women should not delay preventive screening. Regardless of whether you have been vaccinated against COVID-19, you should sign up for your planned mammogram. You should inform your mammography technologist that you have been vaccinated against COVID-19, how many doses you received, and in which arm it was given. This information is helpful in understanding the mammogram images.
In your particular situation, you should consider having your mammogram before your next dose of the COVID-19 vaccine. If this is not possible, inform the technologist of your vaccination status.
Lymph nodes are part of your body’s germ-fighting immune system. Your lymph nodes, also called lymph glands, play an important role in your body’s ability to fight off infection. They act as filters and trap viruses and bacteria before they spread to other parts of the body. Because of this, swollen lymph nodes are common in many people when they are sick. Common areas where you might notice swollen lymph nodes are your neck, chin, armpits, and groin.
When someone is given a vaccine, the lymphatic system is activated. Swollen lymph nodes are a common and harmless reaction to many vaccines, including vaccination against COVID-19. They typically occur under the arm where the shot was fired. The swelling is a sign that your body is responding to the vaccine.
Depending on the amount of swelling, some people may find that their lymph nodes are larger, and these lymph nodes feel tender or painful to the touch. The challenge is that if your health team sees swollen lymph nodes on a mammogram, they want to investigate further. With the reports of swollen lymph nodes related to the COVID-19 vaccination, your health team wants to be extra vigilant and ensure that swollen lymph nodes are related to the COVID-19 vaccination and not breast cancer.
It’s also important to note that swollen lymph nodes don’t appear in every woman who has been vaccinated against COVID-19 and then has a mammogram. Most patients show no changes in lymph node size on mammography.
For those patients who feel swollen lymph nodes in the armpit area, the current standard is to have a mammogram and ultrasound scan of the area. If enlarged lymph nodes are seen on your mammogram but you are asymptomatic, an ultrasound is still likely to be recommended for further assessment. You may be asked to return for a follow-up visit within three months for a repeat scan.
COVID-19 has put everyone on the alert, but my advice to women in general is this: if you can’t get your mammography done before vaccinating against COVID-19, keep your already scheduled mammography appointment and advise the technologist about your vaccination. Encourage your family and friends to keep up to date on their checkups as well. I also tell my patients that skin changes – breast swelling, new lumps or bumps, or nipple discharge – should warrant an imaging test. And that goes for both women and men, as breast cancer can affect both sexes.
Early detection of breast cancer saves lives. Because of this, it is important that you not delay your breast cancer screening no matter what is happening in the world.
Cancer patients are at increased risk of developing serious illness from COVID-19, and vaccination against COVID-19 is a tool used to prevent infections. We are seeing guidelines that say women should be vaccinated against COVID-19 at any stage of breast cancer treatment if they are able. I encourage all cancer patients to get vaccinated against COVID-19 as soon as it becomes available. Whether or not you have been vaccinated against COVID-19, it is still important to practice safe behavior, including wearing a mask in public, practicing social distancing, and performing adequate hand hygiene.
COVID-19 vaccine: should I postpone my mammogram?
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Quote: Mayo Clinic Q&A: Mammograms and COVID-19 Vaccine (2021 May 11), accessed May 11, 2021 from https://medicalxpress.com/news/2021-05-mayo-clinic-mammograms -covid-vaccine.html
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