COVID-19 vaccine can skew mammogram screens
Dr. Adam Fang, of Allegheny Health Network Director of Breast Imaging, advises women to either get their mammogram before they get a COVID-19 vaccination or wait at least four weeks after their second vaccination to get their mammogram.
courtesy of Pam Lynn
Pam Lynn, a perfusionist at AHN’s Allegheny General Hospital who practices goat yoga, is a breast cancer survivor. Doctors are recommending women delay their mammograms until at least four weeks after getting a final COVID-19 vaccination to assure accurate screening results.
AHN Allegheny General Hospital perfusionist Pam Lynn, right, was called for a follow-up appointment after a January mammogram. Swollen lymph nodes from a COVID-19 vaccination required doctors to do additional screening. It’s now recommended to either get a mammogram before a COVID-19 shot, or wait until at least four weeks after the last COVID vaccination.
On Jan. 9, Pam Lynn, a perfusionist at Allegheny Health Network’s Allegheny General Hospital, was among a group of health care workers who received her first COVID-19 vaccination.
Four days later, the breast cancer survivor underwent her annual mammogram.
“They always say, ‘We’ll call you if we see anything unusual,'” said Lynn. “I got a phone call the next day and they asked if I could come back in. They wanted to do an ultrasound because of issues with the lymph nodes on the left side. I got an appointment for about two weeks later, and as a breast cancer survivor, I worried the whole time.”
At the followup exam, Lynn’s doctor was puzzled.
“She said, ‘I’ve looked at your old films and your recent ones, and I can’t explain it, but there was something going on in January but there’s not now,'” Lynn recalled.
The doctor asked if Lynn had gotten a COVID-19 shot at around the time she underwent the first mammogram, and Lynn said yes.
And then the test results made sense.
Dr. Adam Fang, Allegheny Health Network Director of Breast Imaging, said that early in February, he and other doctors noticed that a number of women who they were calling back for further screening because of swollen lymph nodes had recently received a COVID-19 vaccine.
Lynn was perfectly healthy. The swollen lymph nodes were simply a side effect of the COVID-19 vaccine.
The Society for Breast Imaging recently issued new medical guidance recommending that women wait four to six weeks after they receive their final dose of COVID-19 vaccine to get a mammogram because the shots can cause lymph nodes to swell, falsely mimicking a warning sign of breast cancer.
Another option is to get the mammogram before getting the COVID-19 vaccination.
Fang said waiting at least four weeks provides time for the lymph nodes to return to their normal size, and makes it less likely that doctors will have to call a patient back for more tests.
“Having a screening mammogram is vitally important. We don’t want to miss a breast cancer. But we want to reduce unnecessary followups and the stress and anxiety that comes with it,” said Fang.
Swollen lymph nodes are a side effect of other vaccinations, too, so it shouldn’t scare people away from getting the vaccine.
“It’s a sign that your body is doing what it’s supposed to,” said Fang.
Swelling of the lymph nodes is more common following COVID-19 shots.
The Centers for Disease Control and Prevention reports that the side effect occurs in both the Pfizer and the Moderna vaccines – in 11% of people after the first dose of Pfizer, and in 16% of people after the second dose of Moderna.
Fang said AHN has updated its policy at mammogram centers to now ask women the dates they received the COVID-19 vaccine doses, and which arm (swollen lymph nodes typically occur on the same side as where the COVID-19 vaccines were administered).
If the dates fall within the four-week window, women can reschedule. If they choose to keep the appointment, they can, but they’ll be informed that they might have to return.
“If they reschedule, they’re giving that lymph node time to go down and return to normal size and we’ll do the screening mammogram, and if it looks normal they come back the next year,” said Fang. “If they want to keep the appointment, that’s perfectly fine, too. If a woman wants to have a screening mammogram, we will never say no. But they might have to come back for additional imaging. The important thing is, we don’t want to miss anything.”
Fang noted that a number of women have delayed scheduling their mammograms during the COVID-19 pandemic – which has resulted in missed cancer diagnoses – and encouraged them to get their annual mammogram.
Lynn, who received the Pfizer vaccine, emphasized the importance of both.
“Science is amazing,” said Lynn. “I tell my female friends to get the vaccine, it’s important. Get your mammogram, too, but just hold off on it.”