Some advise women without breast complaints to put four to six weeks between a dose of COVID-19 and a screening mammogram. Others, wary of discouraging women from getting either the vaccine or a mammogram, are urging women to come in as soon as they can.
While the members of both expert panels acted quickly to issue their recommendations, they acknowledged that the advice amounted to "expert opinion without data," said Milch, who was among the authors of the Society of Breast Imaging recommendations.
The new guidance was largely based on anecdotal evidence generated in response to the Pfizer-BioNTech and Moderna vaccines. It's not clear yet whether Johnson & Johnson's single-dose vaccine will evoke the same response.
Nor is it clear how long it will take for the swelling in some women's lymph nodes to abate or whether their reactions will be more pronounced after the second shot than after a first.
Radiologists wonder whether some configurations of swollen lymph nodes can be dismissed lightly, while others warn of something more ominous. And they wonder how women's lymph nodes will respond to COVID-19 boost shots, if those prove necessary.
"There's a lot that's unknown," Mullen said.
One message is clear: If a woman has felt a lump in her breast or is experiencing soreness in or around her breast or discharge from her nipple, she should get her symptoms assessed right away.
Here, too, radiologists are quick to point out that the enlarged nodes they are seeing do not amount to a link between the vaccine and breast cancer. "I see no connection whatsoever," Lehman said. "There is not one bit of evidence that would even suggest that."
On the contrary, she said, "I like to think of this as a good thing: In response to vaccine, the immune system is doing the work it's designed to do."
After a year in which screening mammography declined by at least 20% from recent levels — and when there's growing evidence that patients are being diagnosed with more advanced cancers as a result — women certainly should not skip their mammograms after getting the COVID-19 vaccine, doctors said. Nor should they skip the vaccine for the sake of a mammogram.
"The truth is, this is something that has always occurred," Milch said. Only the scale of the phenomenon has been magnified. ___ Distributed by Tribune Content Agency, LLC.