COVID vaccines leading to some breast cancer scares

Swollen lymph nodes can show up in mammogram images after patients receive their COVID-19 vaccines. - Photo: File

One possible side effect of the COVID-19 vaccines is swollen lymph nodes, which has led to breast cancer scares for some women who have found lumps in their armpits after being vaccinated.

According to the American Cancer Society, some people might have swelling or tenderness of the lymph nodes in the armpit on the side where they got the injection – a normal response by the body’s immune system.

“A swollen lymph node under the arm might cause concern, since this can also be a sign of breast cancer, as well as some other cancers. The time it takes for the lymph nodes to shrink back down after the vaccine may be a few days to a few weeks, although this is still being studied. If you notice swollen or tender lymph nodes that do not go away after a few weeks (or if they continue to get bigger), contact your doctor to discuss the next steps,” the American Cancer Society advises on its website.

Lumps caused by swollen lymph nodes can show up in mammograms and scans, and can initially be interpreted as an indication of cancer. Typically, before COVID-19 vaccines were being administered, if a mass was seen on a mammogram, it would lead to follow-up tests, such as biopsies or ultrasounds.

The US Society of Breast Imaging has issued guidelines for mammograms following vaccinations, which recommends that women who attend their scheduled mammogram shortly after being vaccinated should return for follow-up imaging four to 12 weeks later so the radiologist can determine if the swollen lymph nodes have returned to normal size.

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One Grand Cayman resident, who asked not to be named, described finding a lump in her armpit a few days after being vaccinated.

She told the Compass Tuesday, “I totally freaked out. I was sure it was breast cancer and figured if a lump that big, the size of a marble, was in my lymph nodes, I was surely a goner. I had about two days of freaking out before a close friend told me it happened to her friend after the vaccine.

“I googled it and a lot came up about it being a possible side effect. Being that it was under the arm I had been vaccinated in, I felt that was likely the cause. My doctor didn’t seem concerned at all when I mentioned it. The mammogram clinic said they have been seeing a fair bit of it and that I should ask my doctor if I should wait for a mammogram until possible side effects would wear off.”

She said that after doing more research, she found that the common opinion seemed to be to wait four to six weeks after the second vaccine to have a mammogram done unless there was an underlying reason to have it done sooner.

“I decided to wait four to six weeks after the second vaccine to minimise stress,” she said.

Dr. Yaron Rado, chief radiologist at Doctors Hospital, told the Compass that, at the moment, he was seeing a lot of these reactions in mammograms, on ultrasounds and in chest CTs .

“Reactive lymphadenopathy can have many different reasons, and is something we often see without alarming us,” he said.

He added that the swelling of the lymph node is a natural immune response “and it mostly comes with tenderness”.

“The tenderness and the history [of vaccination] give the swollen lymph nodes away as reactive, and we would not follow up on them but would ask the patient to monitor the size, and only when [the swollen nodes] do not go away [to] seek medical advice,” he said.

Rado added, “Mostly breast cancer is a painless swelling or mass, so the tenderness is actually a very good sign.”

Dr. Samantha Digby, general practitioner and medical director of the Cayman Islands Cancer Society, said she has seen several patients in recent weeks who have presented with swollen lymph nodes, usually on the neck or in the armpit on the side where the patient received the vaccine shot.

She said in most cases of those affected, the swollen lymph nodes return to their normal size within two to three weeks. Lumps that persist longer than that should be investigated, she said.

The swollen lymph nodes can appear either after the first or second of the vaccine doses, Digby said.

“If you are concerned, visit your physician, who can decide if it is something you need to worry about or not,” she said.

She added that there is no indication of any long-term risk or impact relating to lymph nodes swelling in reaction to the vaccine.

A person scheduling a routine mammogram is advised to book it at least four weeks after receiving their second vaccine dose. However, medical experts are asking patients who already have a scheduled mammogram or scan booked to keep that appointment even if they have been recently vaccinated, but to let the facility know when they received their vaccine.

Cancer specialists have already raised concerns that COVID restrictions have led to late diagnoses of many cancers because hospitals were not offering regular screenings or patients chose to avoid medical facilities out of fear of contracting the virus.

In Cayman, cancer charities say they are bracing for an increase in cancer cases. For example, Janette Fitzgerald of the Breast Cancer Foundation said in February that since the last week of December, it had seen about 20 new patients – more than double the number it would typically see in that timeframe. Of those, about half had late-stage cancers.

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