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Routine mammograms following COVID-19 vaccination

March 1, 2021

We want to inform our patients of changes to routine mammography following COVID-19 vaccination. Enlarged axillary (armpit) lymph nodes are a known side effect of the COVID-19 vaccine. However, when unilaterally enlarged lymph nodes are seen on a screening mammogram it often prompts additional imaging evaluation, and subsequent follow up imaging and/or biopsy.

In order to help minimize the need for additional work up, the Society of Breast Imaging (SBI) has recommended the following considerations for patients and providers scheduling screening mammograms: If possible, and when it does not unduly delay care, consider scheduling SCREENING exams prior to the first dose of a COVID-19 vaccination or 4-6 weeks following the completion of a COVID-19 vaccination regimen.

It is also suggested to follow this timeline for scheduling screening mammography in regards to flu and shingles vaccinations as well.

If patient’s have their screening mammogram sooner than 4-6 weeks post completion of a COVID-19 vaccination regimen, and large lymph nodes are present that are ipsilateral to their vaccination arm, the radiologist may recommend immediate work-up as well as potential short-term follow-up, if indicated.

If patients present clinically with ipsilateral palpable axillary nodes post COVID-19, flu or shingles vaccination, please consider waiting for 3 months if an acceptable alternative for the patient rather than immediate ultrasound work-up.

Key Points:

  • Schedule screening mammography 4-6 weeks post vaccination, if possible
  • Enlarged axillary lymph nodes are a known side effect of the COVID-19 vaccine
  • Additional screening may be recommended if enlarged lymph nodes are present on a post COVID vaccine mammogram
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