THURSDAY, February 11, 2021 (HealthDay News) – A side effect of the COVID-19 vaccination is creating undue fear among women, making them fear that they may have breast cancer.
Both Pfizer and Moderna vaccines can cause swollen lymph nodes, particularly those in the armpit on the side where the injection was given, experts say.
Some women are feeling these lymph nodes in their armpits and mistaking them for breast lumps, according to a recent report.
In addition, these swollen lymph nodes may appear on a mammogram, even though women cannot feel them. This prompted the Society of Breast Imaging to recommend that women postpone any scheduled mammograms within four weeks after their last injection of COVID-19.
Swelling of the post-vaccine lymph nodes is common and harmless, but doctors fear it may cause undue fear among women. It can also trigger a false positive on a mammogram, increasing the need for unnecessary additional tests, said Dr. Brett Parkinson, medical director of the Intermountain Medical Center Breast Care Center in Murray, Utah.
“It is very unusual to see enlarged lymph nodes in the normal screening population. We only see about 0.2% to 0.4% of the time,” said Parkinson.
“So when we see this, it raises a red flag, because when this type of lymph node swelling is present, about 50% of the time, it can represent metastatic breast cancer that went from the breast to the lymph node under the arm, or leukemia or lymphoma, “he added.
When doctors see this, they want the patient to come back. “We do additional tests, usually ultrasound, and we often do a biopsy to rule out one of these malignancies,” said Parkinson.
Extra screening
He noted that about 16% of patients in the clinical trial had enlarged lymph nodes after the second injection of the Moderna vaccine, and the Pfizer vaccine had a similar effect.
“I actually had a palpable armpit [armpit] lymph node after my vaccination, “said Parkinson.” This also happens in men. “
A series of case reports published recently online in the newspaper Clinical Imaging detailed four women who received the COVID-19 vaccine and then sought breast screening.
Some were concerned that they might get breast cancer. For example, a 59-year-old woman with a family history of breast cancer received targeted ultrasound to assess a lump in her left armpit, nine days after receiving the Pfizer vaccine, according to a team report from Weill Cornell’s radiology department. at the NewYork-Presbyterian in New York City.
Others received a false positive. This was the case for a 42-year-old woman who had a routine mammogram and was diagnosed with multiple swollen lymph nodes in her left armpit. She then had to return for a follow-up ultrasound exam to rule out the cancer.
Aubrey Lewis, a nurse at University Hospitals in Cleveland, said ABC news she initially had no side effects with the Modern vaccine, but after a few days she found swelling in one of her lymph nodes.
“I felt under my armpit to see if there was anything there and I felt a lump. It was kind of difficult, but still mobile, it moved,” said Lewis.
“I was like, ‘This is a weird point for having a sensitive lymph node’, but as soon as I put two and two together – who had just received the COVID vaccine on that side – I realized it was related to that,” she continued.
Based on these cases and the recommendation of the Society of Breast Imaging, several health systems across the country are asking women to delay their mammogram for at least a month after vaccination, said Parkinson.
“What we are doing at our facility is to signal that it says, ‘If you have had the COVID vaccine in the past four weeks, speak to our reception and we will give you the opportunity to speak with one of our providers at the clinic,'” he said. “We give women the option of going ahead and having a mammogram, but with the notion that they are summoned back.”
Know the signs
Women who find a swollen lymph node in the armpit of the arm, where they received the COVID-19 vaccine, should not automatically suspect breast cancer, Parkinson added.
“We want to tell these patients, take a deep breath and if it disappears within three to four weeks, just come for your regular checkup,” he advised.
However, doctors want to see women if they have any of the other signs and symptoms of breast cancer, vaccination or not, Parkinson said.
According to the US Centers for Disease Control and Prevention, they include:
- Thickening or swelling of part of the breast.
- Irritation or undulation of the breast skin.
- Redness or scaly skin in the nipple area or on the breast.
- Nipple contraction or pain in the nipple area.
- Nipple discharge other than breast milk, including blood.
- Any change in the size or shape of the breast.
- Pain in any area of the breast.
“These are worrying signs, and you should still go in,” said Parkinson. “We don’t want women to postpone this.”
More information
The US Center for Disease Control and Prevention has more information about COVID-19 vaccines.
SOURCES: Brett Parkinson, MD, medical director, Intermountain Medical Center Breast Care Center, Murray, Utah; ABC news; Clinical Imaging, January 18, 2021, online