Health experts are stressing the importance of an annual mammogram, even during a pandemic, but warning that undergoing the screening too close to receiving a COVID-19 vaccine could impact what comes up on that scan.A mammogram takes an X-ray picture of the breast to detect early signs of breast cancer."Regular mammograms are the best tests doctors have to find breast cancer early, sometimes up to three years before it can be felt," according to the Centers for Disease Control and Prevention.“You never want to ignore anything that’s going on in your breast. If you feel a lump or have any pain then certainly come and see us,” said Dr. Kelly Cronin, the medical director and section head of breast imaging at Wake Forest Baptist Health in North Carolina. Cronin explained that during a mammogram, the image often captures “up into the underarm area, which is where a lot of lymph nodes will live.” She said after a vaccine, like the COVID-19 vaccine, lymph nodes under the arm can become swollen, mirroring one of the early detection signs screeners look for in mammogram images. Cronin said Wake Forest Baptist Health is encouraging women to keep coming in for the annual exam, but to ensure it is two to four weeks after receiving the second dose of the COVID-19 vaccine to ensure there isn’t unnecessary confusion or worry for patients and their families.Novant Health’s Dr. David Priest said they’re suggesting patients wait four to six weeks between second doses and mammogram appointments.“Lymph nodes tend to swell after vaccination because the immune system is responding to the vaccine,” Priest said. “To prevent confusion or false results on a mammogram, we’re recommending that women should consider scheduling their routine screening mammograms.”Priest stressed the guidance was for regular, screening mammograms. Women with symptoms, with abnormalities or concerns, should not delay, he noted. Priest encouraged women to discuss timing with their providers. Cronin said, at Wake Forest, mammograms are being done with COVID-19 precautions in place. “Getting a routine, annual mammogram is so important,” Cronin said. “If you haven’t had a mammogram in over a year and you’re over 40, certainly come back in and get that scheduled. We’ll get it taken care of safely.”Both medical systems put out the recommendations following the Society of Breast Imaging’s guidance on the matter.

A side effect of the COVID-19 vaccine could lead to unnecessary concern surrounding a woman's annual mammogram. Both the COVID-19 vaccine and breast cancer can cause swollen lymph nodes in the underarm area. For that reason, some doctors are encouraging patients to wait as little as four or as many as ten weeks before having a mammogram after vaccination. Dr. Jennifer Manders, a breast surgeon and the president-elect of the medical staff at Christ Hospital, does not fall under that school of thought. "The concern is that if you have enlarged lymph nodes from your shot because you're having a reaction to your shot, which is totally normal, that the radiologist may interpret this as, 'Oh, there's a potential problem and we need to do a biopsy or at least further images," Manders said. "It could be a false positive."She is a firm believer in the importance of early detection. "Some of the recommendations have been to wait, and to reschedule your mammograms. It's hard to know exactly how long reactive lymph nodes stick around. It could be three to four weeks, in some cases," she said. "What we're telling patients is not to wait." Vaccinations are intended to cause an immune response. "The reaction in the lymph nodes is actually a normal response that your body has because what the vaccine is doing is it's activating your immune system. You're creating antibodies," Manders said.Many hospitals in the state were forced to cancel preventative screenings, including mammograms, at the start of the COVID-19 pandemic. "Some women who had breast cancer had to delay diagnosis because of that," Manders said. Her goal this year is to get her patients back on track. She recommends that patients talk to their doctor before deciding to postpone an annual mammogram. "If you alert the staff that, 'Hey, I just got my shot in my right arm,' and they see some lymph nodes on the right that maybe look a little bit plump, they might say, you know, let's check back in a month," she said. "Still proceed with a mammogram. We're trying to keep women on target in terms of getting their screenings done and making sure that there's nothing going on."