Breast imaging and COVID-19 vaccine: Don’t delay cancer screenings

Questions have surfaced about the timing of annual breast imaging exams and the COVID-19 vaccine because swollen lymph nodes have shown up in the mammograms and other imaging scans of women who have been vaccinated, raising alarm about the possibility of breast cancer.

While the questions are valid, one thing remains clear: Women should maintain their annual breast imaging schedule. Early detection remains the best treatment for breast cancer. Here are commonly asked questions and what you need to know:

How concerned should I be about exposure to the coronavirus?

Multiple strategies are in place to minimize exposure to the coronavirus in healthcare settings. Appointments are staggered to avoid crowding. Patients are screened regarding recent travel, and temperature checks are conducted before exams. Healthcare providers have largely been vaccinated. Masks, hand sanitizing and social distancing are required by all.

Why are people developing swollen axillary lymph nodes after getting the vaccine?

This is not a new phenomenon related exclusively to the COVID-19 vaccine. In the past, radiologists have seen swollen lymph nodes caused by the flu vaccine, tetanus shots and other injections. It is natural that an injection meant to create an immune response would cause lymph nodes to temporarily swell. Radiologists see this in about 10 to 15 percent of patients.

Should I consider changing the timing of my COVID-19 vaccine?

Patients should not change the timing of their vaccine. Getting vaccinated remains a top health priority. If the vaccine is available, sign up and get it.

Why might I need a follow-up exam?

If swollen lymph nodes were seen on a breast imaging study after you were vaccinated, you may be asked to return in three months for a follow-up ultrasound to document that the lymph nodes have reduced in size.

Can I get injected on the same side that underwent lymph node surgery?

If you have a choice, it may be more comfortable to receive the vaccine on the side that has not had lymph node surgery. Some patients either have lymphedema (arm swelling) or are at high risk for lymphedema following an extensive lymph node dissection after radiation.

What if I had minimal axillary surgery on one side, and a recent shoulder replacement on the other?

In that case, you might opt to have the injection on the same side as the breast cancer surgery. If lymph nodes have been removed from both armpits, then consider using your non-dominant arm to minimize discomfort.

I’m getting the COVID-19 vaccine in two weeks and my breast imaging tests are booked for four weeks. Should I postpone or skip the breast imaging tests this year?

Drawing from the expertise of the Society of Breast Imaging and Yale New Haven Health, women should not skip their annual breast imaging. If maintaining your breast imaging schedule gives you peace of mind, then continue the regimen. But don’t be surprised – or get more anxious – if asked to return for a follow-up exam. If you want to reschedule based upon the timing of the vaccine, wait four to six weeks for your breast imaging.

Sources: Barbara Ward, MD, medical director, Breast Center; Linda LaTrenta, MD, director, Breast Imaging and Janet Freedman, MD, Physical Medicine/Rehabilitation