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Guideline: Expert guidelines on COVID-19 vaccines and timing of breast screening tests

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Contents

At a glance What does this mean for me?
In the news Guidelines
Vaccines, and screening Questions for your doctor
When should you have screening? Resources

 

AT A GLANCE


What is this news about?

In response to news media reports of swollen being seen on mammograms following COVID-19 vaccinations, the Society for Breast Imaging released recommendations regarding the best timing for mammograms after having a COVID-19 vaccination.

 

Why is this news important?

and COVID-19 vaccines are both important for your health. Because reports of swollen seen on are increasing, a few professional societies have issued patient guidelines for when to schedule .  Guidelines have also been issued for healthcare providers regarding how to interpret swollen that are detected by after vaccination for COVID-19.

 

In the news

Recent headlines on COVID-19 vaccinations and , including the following examples, can be confusing and scary, while others do not tell the whole story:

  • “Mammograms pick up swelling due to COVID-19 vaccine, causing unnecessary fear, radiologists say.”
  •  “It can be alarming: COVID vaccine side effect may be mistaken as breast cancer.”
  • “COVID-19 vaccine: Should I reschedule my ?”
  • “Why you should reschedule your if you recently got the COVID-19 vaccine.”
  • “Swollen , one COVID-19 vaccine side effect, could be misread as cancer, experts warn.”

 

COVID-19 vaccines, swollen and

Some people develop swollen following a COVID-19 vaccination. This a harmless and temporary response by the immune system to the vaccination. Swelling that develops in the underarm of the arm where the shot is given is a normal response to vaccination.  It is a sign that the vaccine is working and that the immune system is responding. This swelling usually disappears in a few days or weeks. 

If you have recently had a COVID-19 vaccination, may detect swollen .  Rarely, swollen can be a sign of breast cancer. If swollen are seen on your , you may be encouraged to return to the breast center for an of your underarm and/or have a follow-up exam to confirm that the have returned to their normal size.

Allison W. Kurian, MD, FORCE Advisory Board Director Emeritus, said,“I had substantial axillary lymph node swelling after my second dose of the Pfizer vaccine and I have been telling all my patients, so they won’t be worried. Glad you [FORCE XRAY] are getting the word out!"

 

When should you have ?

Try to schedule your at least four weeks after your second dose of vaccine or before your first dose of COVID vaccine (Moderna or Pfizer-BioNTech vaccines). Swollen were not listed among the reported side effects in a briefing released by the Food and Drug Administration about the Johnson & Johnson Covid vaccine.

The following recommendations apply if you have already scheduled your and vaccine:

  • If you have a scheduled right after your first or second vaccine, try to reschedule it so that you have the screening before your first shot or 4 weeks after your second shot.
  • If you are overdue for a or cannot reschedule, keep your appointment for the COVID-19 vaccination.
  • If you have a after your COVID-19 vaccination, provide your screening technician with the following information:
    • the date of your vaccination
    • whether the vaccine was given in the left or right arm or thigh
    • whether your vaccination was your first or second dose

This important information will help the breast radiologist to better interpret your .      

The following is recommended if you have been diagnosed with breast cancer:

  • request that you be given the shot in the arm that is opposite the side on which your breast cancer was diagnosed or in your thigh.
  • follow your oncologist’s and/or radiologist’s recommendations, which may include additional imaging or biopsy, if you have swollen after your vaccination.

For more information see our XRAY Guideline: COVID vaccines for people with cancer here.

 

What does this mean for me?

Both breast and COVID-19 vaccines are very important for your health. Getting vaccinated is critical to stop the spread of COVID-19. Having regular helps save lives by detecting breast cancer as early as possible. If you are significantly overdue for a , it is important to schedule and keep your appointment even if you have recently been vaccinated. Ideally, schedule your to occur before vaccination or four weeks after your last dose of vaccination.

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posted 3/30/2021

 

References

Grimm L, Destounis S, Dogan B, et al. SBI recommendations for women receiving the COVID-19 vaccine.

Lehman CD, D'Alessandro HA, Mendoza DP, et al. Unilateral Lymphadenopathy After COVID-19 Vaccination: A Practical Management Plan for Radiologists Across Specialties. Journal of the American College of Radiology. Published online March 4, 2021.

Lehman CD, Lamb LR, D'Alessandro HA. Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach. American Journal of Roentgenology. Published online February 22, 2021.

 

Disclosure

FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.

This article is relevant for:

People considering screening mammography after getting a COVID-19 vaccine.

This article is also relevant for:

Healthy people with average cancer risk

People with a genetic mutation linked to cancer risk

People with a family history of cancer

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Expert Guidelines
Expert Guidelines

 COVID-19 initial vaccination guidelines

  • All people ages 5-17 should be vaccinated with the Pfizer vaccine and people 18 and older should be vaccinated with a Moderna, Pfizer or Johnson & Johnson vaccines unless contraindicated (e.g., known allergic reaction to a vaccine component). 
  • People should be vaccinated even if they have already had a COVID-19 infection.
  • COVID-19 vaccination is recommended for people who are pregnant, breastfeeding, trying to get pregnant now, or might become pregnant in the future.
  • People ages 5 or older with a weakened immune system, should get a COVID-19 vaccination (if they have no other contraindications). People with a weakened immune system may have a reduced immune response.
  • People with an autoimmune condition, may receive an mRNA COVID-19 vaccine. 

COVID-19 booster recommendations  

  • The following people who received Pfizer or Moderna vaccines for their initial shot series should receive a booster at least 6 months after receiving their 2nd dose:
    • All people age 50 and older.
    • People who are 18 and older who live in a long-term care facility. 
  • The following people who received Pfizer or Moderna vaccines for their initial shot series may receive a booster at least 6 months after receiving their 2nd dose:  
    •   People who are 18 and older. 
  • People who received Johnson & Johnson for their initial shot series should receive a booster at least 2 months after receiving their initial dose. 
  • Moderately to severely immunocompromised people ages 12 years and older who completed their Pfizer vaccine primary series and ages 18 years or older who complete their Moderna COVID-19 vaccine primary series should plan to get an additional primary dose followed by a booster dose.

NCCN booster recommendations for people diagnosed with cancer

NCCN released recommendations for the following people diagnosed with cancer to receive COVID-19 boosters at least four weeks after their second dose of Pfizer or Moderna.  

  • Patients who have received cancer treatment within 1-year of their initial vaccination or are actively being treated, including those undergoing chemotherapy, , hormonal therapy, surgery, radiation or treatment with therapy that is currently used only in an experimental setting (e.g., a clinical trial).
  • Patients with newly diagnosed cancer or recurrent cancer who will receive cancer treatment in the future.
  • Patients with cancer of the blood regardless of whether they are currently receiving treatment.
  • Patients who have received a stem cell transplant or engineered cellular therapy (e.g., CART cells).
  • Patients who have had COVID-19 after their initial vaccine series should also get a booster (delayed more than 28 days after completion of the first series and documented clearance of the virus).

The NCCN guideline update did not address people who received the one-shot Johnson & Johnson COVID-19 vaccine.

Updated: 11/28/2021

Questions To Ask Your Doctor
Questions To Ask Your Doctor

  • When should I have a if I have been vaccinated for COVID-19?
  • I have not yet been vaccinated for COVID-19; when should I schedule my ?
  • I am experiencing swollen following my COVID-19 vaccination. What should I do?

Open Clinical Trials
Open Clinical Trials

The following are studies on COVID and cancer:

Updated: 11/30/2021

Who covered this study?

Cancer Health

Enlarged lymph nodes after COVID-19 vaccine may be mistaken for cancer metastasis This article rates 4.0 out of 5 stars

Good Morning America

New warning about women getting mammograms after getting vaccine This article rates 3.0 out of 5 stars

How we rated the media

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