Due for a mammogram? Consider timing your breast cancer screening around the COVID-19 vaccines to avoid an unnecessary follow-up visit.
Here's why: Vaccines can cause lymph nodes to swell, making it difficult to distinguish between an expected antibody response and something more serious – like breast cancer.
If possible, and when it does not delay care, annual breast exams should be scheduled before the first dose of a COVID-19 vaccination or at least four to six weeks following the second dose, according to the Society of Breast Imaging (SBI).
The same guidelines apply to booster doses, as well, said Dr. Nicole Abinanti, director of women's imaging at Mecklenburg Radiology Associates.
"People who are eligible for a third COVID vaccine dose must wait 6 months after they were fully vaccinated to receive a booster. That six-month waiting period is a great time to get a mammogram," Abinanti said. "Just be certain it's been at least four to six weeks since your second dose."
Already got your booster? The same advice applies. Schedule your mammogram at least four weeks after receiving the vaccine.
Who needs a mammogram?
Novant Health recommends that women who are asymptomatic with an average risk of breast cancer receive an annual mammogram beginning at age 40. Those with a significant family history should speak to their physician or have a high-risk assessment done to determine if they need to start earlier screening.
Mammograms and COVID-19 vaccines
Some people experience swelling in their lymph nodes (lymphadenopathy) in the underarm near where they got a COVID-19 vaccine. This swelling is a normal sign that your body is building antibodies.
In clinical trials, Abinanti said up to 16 percent of patients experienced axillary lymphadenopathy after receiving the COVID-19 vaccine. This is an expected side effect, but it's also possible for that swelling to cause a false reading on a mammogram.
“Typically, if we see axillary lymphadenopathy in a screening mammogram, the patient will come back for an ultrasound and if the lymph nodes are still enlarged, we recommend a biopsy,” Abinanti said. “The current SBI guidance is not to go right to biopsy if there has been a recent vaccine given on the side of the enlarged lymph nodes, but to offer the patient a follow-up appointment about eight to 12 weeks after the second dose of the COVID-19 vaccine to make sure the lymph nodes are decreasing in size.”
This follow-up appointment can typically be avoided by timing the COVID-19 vaccines after a mammogram or scheduling your screening mammogram six weeks after your second vaccine dose. But if you or your health care provider have a breast-related concern, do not delay your breast diagnostic exam.
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Let your physician know
When women get a mammogram, Abinanti suggested they notify their physician if they received the vaccine, as well as which arm it was administered in. This extends to people who receive annual magnetic resonance imaging, also known as an MRI.
“We are asking all of our patients if they’ve gotten the vaccine. So, this doesn’t only apply to patients that are getting mammograms. "Abinanti said. “It also applies to women receiving a high-risk screening MRI.”
She added that any woman – regardless of age – who experiences a lump under the armpit area following a COVID-19 vaccine should consult with their doctor.
“Let your physician know and make sure they follow you until it resolves, because there could be something else going on and it just happens to coincide with the COVID-19 vaccine. We want to make sure people don’t ignore signs and symptoms that could be potentially significant,” Abinanti said.