New mammogram guidance surrounding the COVID-19 vaccine has been in the news and on social media lately. That’s because the Society of Breast Imaging (SBI), one of the leading breast imaging organizations in the country, has issued guidelines for breast imaging and the COVID-19 vaccine.
The reason for these guidelines is axillary adenopathy, or the swelling of lymph nodes in the armpits. This swelling is rare in women with an otherwise normal screening mammogram occurring in 0.02-0.04% of screening mammograms.
Studies around the COVID-19 vaccine have found that a possible side effect can be swelling and tenderness of the lymph nodes, particularly those in the armpit. Approximately 11.6% of patients who received the Moderna vaccine had swelling or tenderness following the second shot. The side effect was less prevalent in the Pfizer-BioNTech vaccine but it did happen. The SBI noted that the incidence of this side effect could possibly be higher but has gone unnoticed by vaccine recipients.
This side effect is not a surprising one. Your body has a network of lymph vessels and lymph nodes that are part of your immune system. They collect fluid, waste, and other things like viruses and bacteria that are in your tissues and bloodstream. Lymph vessels carry lymph fluid through your body like blood vessels. Lymph fluid does a few things but one important function is the ability to fight infections through the white blood cells it carries.
When your body is working to fight infection and build immunity to a virus or bacteria, the node in a particular area may swell or enlarge as it tries to filter out bad cells. While the swelling is usually indicative of your body fighting infection, it can be a sign of cancer in an area.
The swelling/tenderness in the armpit from a COVID-19 vaccine could cause a woman to worry about breast cancer. The swelling could cause a false reading on her breast imaging or make her worry that she’s developed a lump. Not only can this cause a lot of stress for women, it can also mean unnecessary follow-up testing.
So what should you do if you are eligible for the COVID-19 vaccine but also need a screening mammogram or breast MRI?
If at all possible, the SBI recommends considering scheduling your mammogram or breast MRI before your first dose of the COVID-19 vaccine or 4-6 weeks after your second dose. However, screening mammograms and breast MRIs are important so if scheduling imaging around vaccination would unduly delay care, you can still get your mammogram or breast MRI. Talk to your doctor if you have concerns about getting or delaying your imaging due to the vaccine.
If you choose to go forward with your screening mammogram or breast MRI after your vaccine, let the technologist know that you have had the vaccine. They can make a note on your intake form so the physician reading it can take that into consideration when they review your imaging.
Most of all, women should know that this side effect is normal with the COVID-19 and does not necessarily indicate a problem in your breasts. If you notice swelling or tenderness after the vaccine, monitor to see if it subsides and contact your doctor if you have any concerns.
Karen Darr is the Director of Imaging Services at Fisher-Titus. Fisher-Titus offers 3-D mammography and curved paddles. Talk to your doctor to see if you should be getting a regular screening mammogram. For more information, visit fisher-titus.org/breast-health.