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National Organization Recommends Delayed Mammography Screening for Women After COVID-19 Vaccine

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The Breast Imaging Association has recommended that women undergo a mammogram either before receiving a COVID-19 vaccine or wait for a breast imaging sometime between four and six weeks after receiving the second dose of the vaccine.

One of the side effects of vaccines involves enlarged lymph nodes in the recipients, which may raise a red flag during a mammogram.

The guidelines (Breast Imaging Society) include a statement to consider screening mammograms for COVID-19 vaccines because, after administering the vaccine, temporary enlargement of the lymph nodes can be seen. Clayton Taylor, a breast radiologist at Ohio State University Cancer Center Arthur G. James Cancer Hospital, said in an interview with SH CRIMI. This enlargement of the lymph nodes, a sign that the body is responding appropriately to the vaccine, can occasionally be seen in the armpit or armpit area on a screening mammogram. If seen on a mammogram, these enlarged lymph nodes may cause unnecessary additional images, such as an ultrasound-focused assessment of the area.

The national organization cited certain side effects data that demonstrated that patients receiving COVID-19 vaccines developed by Moderna or Pfizer-BioNTech were more likely to experience swollen lymph nodes, which lasted an average of one to two days. on the Moderna arm and an average of 10 days on the Pfizer-BioNTech arm.

The concern, according to Dr. Debu Tripathy, is that information from those tests includes adenopathy (swollen lymph nodes) reported by patients who did not include radiographic images.

At the radiographic level, what a mammogram might call an abnormal node may be higher than that and may go on longer than that, Tripathy, who is chair of Breast Medical Oncology at MD Anderson Cancer Center in University of Texas at Hjston and editor-in-chief of SH CRIMI, said in an interview with SH CRIMI. So while I think the guidelines (Breast Imaging Society) are reasonable, if (people) have (their) choice about screening mammograms and getting the COVID vaccine, it is best to get the vaccine right after the mammogram of them. Or, if you have already done the vaccine and it is time for your mammogram and you do not want to delay it too long, I will at least wait for what it says (Breast Imaging Association). And if you want to give yourself a good measure of not having to get a false positive result, I would say wait even longer.

Without the right answer

Although there is no exact answer to how many false positive results can occur from getting a mammogram after getting a COVID-19 vaccine, Taylor says the risk is likely to be small.

Anecdotal, in our experience over the past two months, the risk appears to be very low as long as we know patient information regarding the administration of the COVID-19 vaccine, he said. If a woman and her provider are very concerned about the possibility of additional false positives, we are suggesting that they schedule their screening four to six weeks after the vaccination is completed.

However, Taylor (who was not part of the recommendations) said the most important thing for women to do is get their COVID-19 vaccines and get tested.

“I appreciate the communication and guidance from the (Breast Imaging Society) given that COVID-19 vaccines are new and will be widely administered,” he explained. However, I think screening mammograms can be interpreted safely and accurately in patients who have recently received the COVID-19 vaccine as long as the vaccination information has been collected, as recommended by the (Breast Imaging Association) .

The concern about this, however, according to Tripathy, is any risk of a false positive is still a risk for unnecessary pursuit.

I think, as good as mammograms are, they can not always distinguish between benign (non-harmful) and malignant (cancerous) adenopathy, Tripathy said. There are several characteristics that point to each other. It may be true that an expert mammogram will be better at resolving this, but it will not go to zero versus 100%. So, I think it still makes sense (to wait). Because, I will tell you, even an expert mammographer who sees a large nodule, they will want to follow. A screening mammogram can definitely be delayed, I think it is better not to have a false positive if you only delay it for a month.

Women with symptoms should be checked regardless of time

Part of the suggested recommendations providers ask patients for their COVID-19 vaccination status, including when they received it and on which side the vaccine was delivered. Furthermore, to reduce patient anxiety, the suggested recommendation providers inform patients that vaccines can cause temporary swelling of the lymph nodes.

It is also recommended that women who have recently received a vaccine and have had a positive result during the initial screening be followed up with four to 12 weeks after the end of their second dose.

Tripathy and Taylor, however, both noted that women who are showing symptoms related to breast cancer should be checked immediately and not wait despite the recommendation.

Women who are symptomatic and need breast images, such as a breast lump, should definitely not delay seeking breast imaging or care because of COVID-19 vaccinations, Taylor said.

If you are a super high-risk person, or if you are going in for a diagnostic mammogram, you are coming in because you have a lump, Tripathy said. And they are diagnostic mammograms, not screening mammograms, which are different.

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