COVID-19 Vaccination Impacts When Routine Mammogram Should Be Scheduled

03/09/21

CHI Memorial’s MaryEllen Locher Breast Center is adopting the recommendations of the Society of Breast Imaging for managing axillary adenopathy, changes in size and/or consistency of lymph nodes in the armpit, in patients who have recently received a COVID-19 vaccination.  

Some women may have enlarged lymph nodes in the armpit area after receiving a COVID-19 vaccine.  “Broadly, we are seeing a number of women – up to 10 to 15% – who will have soreness, tenderness, and swelling after receiving the two vaccines currently in use to protect against COVID-19 – Moderna and Pfizer-BioNTech,” says Taylor Rowlett, MD, chief of radiology at CHI Memorial. “Most of these symptoms will develop in the first two or three days from vaccine injection and last for a week to 10 days before swelling subsides.”

While disconcerting, these potential side effects mean the body is producing the intended immune response and generating antibodies. Women should not be alarmed about the change in lymph nodes in the short term.

Because the detection of enlarged lymph nodes on a mammogram may result in a woman being called back for a recheck and/or further screening due to the presence of abnormalities on the screening exam, the MaryEllen Locher Breast Center staff will attempt to schedule screening mammograms with vaccine dosing in mind – scheduling either before the day of a woman’s first vaccine or waiting eight weeks from the date of her first vaccine dose. This will help minimize unnecessary call backs for the temporary side effects from COVID-19 vaccination.

Patients already on the schedule for a mammogram will be asked a series of questions as part of the screening process, and answers will be noted on the patient’s self-assessment, including which vaccine they received and in which arm.  Going forward, screening mammogram appointments will be scheduled eight weeks after the first vaccination dose (or four weeks after the second dose). Patients will be scheduled four weeks after a Johnson & Johnson vaccination dose. Those who do not wish to wait several weeks will be counseled that this decision could lead to unwarranted call backs.  

“We are all learning in real time the possible side effects of the Moderna, Pfizer, and the recently approved Johnson & Johnson vaccines and how they will impact breast cancer screening and potential unnecessary follow up evaluations,” says Dr. Rowlett. “We continue to keep a close eye on our patients at The MaryEllen Locher Breast Center as well as follow the guidance of the professional societies that inform best practices in breast cancer detection.”

To schedule a mammogram at any of the MaryEllen Locher Breast Center’s four locations or the mobile mammography coach, call 423.495.4040.  For more information about the MaryEllenLocher Breast Center, visit MaryEllenLocher.com.