The Modern vaccine was then made available to the city’s health professionals. She received her first shot of Covid-19 about a week before her scheduled mammogram.
Quasha did not notice much reaction to the vaccine at first, but a couple of days before the appointment his left arm began to hurt.
Tender and swollen lumps developed under the left armpit, along with severe inflammation above the collarbone, all areas where the body has lymph nodes, body filters for germs.
“You have lymph nodes above and below the collarbone,” Quasha said. “You don’t want to hear them. I was scared when I heard it.”
Lymph nodes contain immune cells that help fight invaders. This is because it made sense to Quasha that the nodes reacted to the vaccine, creating antibodies as they were designed. But I couldn’t be sure.
The swelling was only on the left side where he had received the shot, the same side as the worrying lump. Was it a reaction to the vaccine or another sign of breast cancer?
“It was like gunpowder”
After the ultrasound, Quasha’s radiologist was worried. He told Quasha that he thought it was the lump he had felt in his chest of little importance, but the lymph nodes that appeared as white spots on her mammogram were something else.
In non-pandemic times, this finding would trigger alarms, which would require further investigation, even an immediate biopsy. Still, Quasha had just had the vaccine. After talking to her, Quasha said her doctor decided not to do a biopsy at that time. Instead, he told Quasha to have a follow-up ultrasound again in six weeks.
Similar scenarios had been happening in mammography centers across the country. As radiologists compared notes with colleagues, the news began to spread.
“We started talking about it and it was like gunpowder,” said Dr. Connie Lehman, head of breast imaging in the Massachusetts General’s radiology department.
“I can’t tell you how many women show nodes on mammograms and people thought it wouldn’t be so common,” said Lehman, who is also a professor of radiology at Harvard Medical School.
“We wanted to advocate that women don’t always need to have a biopsy,” Dr. Lars Grimm said. associate professor of radiology at Duke University School of Medicine and one of the authors of the SBI advisor. “Often, by default, if you see swollen lymph nodes in a patient, it would be to recommend a biopsy.”
Lehman of the General Mass agreed. “When you hear hooves, don’t think of zebra,” he said. “If a woman had a vaccine on her arm on the same side and her lymph nodes are swollen, that’s a normal biological response. It’s totally expected. It just doesn’t make sense to start taking pictures.”
That doesn’t mean women who want to be sure about their cancer status can’t perform a biopsy, Grimm stressed.
“You actually have some women who want to do a biopsy,” she said. “You could tell them,‘ Hey, I think this is due to your Covid vaccine, and I’m sure it will resolve in a few weeks on its own and you’ll be fine. ”But that patient tells you,“ I won’t be comfortable waiting, I want to know now. “
Focus on projection to save lives
For Quasha, the knowledge that many women experienced the same type of reaction to the vaccine was a relief from the worry. After a discussion with her doctor, she said she no longer needs follow-up control.
“I was very reassured,” Quasha said. “The point here is that there are a number of side effects of the vaccine that are not dangerous, but can sometimes increase patients’ anxiety.”
Instead of getting women back to doing an unnecessary ultrasound, radiology centers should focus on scheduling women who have lost their mammograms or are left behind, Lehman said.
“We need to take care of the large percentage of women who were not examined because of the stops during Covid,” she said. “At Mass General alone we have failed to detect 15,000 women because of Covid and we are still trying to get them back.
“This is not where I have to start doing axillary ultrasounds, because someone had a vaccine and the lymph node swelled. It’s just not practical or pragmatic or putting our patient’s needs first,” he said.
It’s not just breast cancer, Lehman stressed. Lymph nodes in other parts of the body also react to vaccines against Covid-19, causing unnecessary procedures in people with other forms of cancer.
“There have been some fake scares and some unnecessary biopsies because people didn’t think to ask it and they assume the node was the cancer that was coming back,” he said.
What to do?
To avoid unnecessary worries, SBI recommends that women schedule any routine annual breast inspection before receiving the Covid-19 vaccine. If a woman has already had the vaccine or is expected to do so soon, the company suggests waiting at least four to six weeks after the second dose before scheduling the appointment.
At Mass General, Lehman and his team have taken it a step further. They are examining all women regardless of the status of the vaccine, but they tell those who have no history of cancer that any swelling of the lymph nodes that could be connected to a Covid-19 vaccine is benign, that is, non-cancerous.
“If their concern is inflammation or tenderness after the armpit vaccine, we suggest they wait four to six weeks, talk to their doctor, and if it persists, we will have them come for an evaluation.” she said.
Whatever you do, experts point out, don’t miss breast cancer screening when it’s recommended. A study published Tuesday in the journal Radiology, which followed more than half a million women, made it clear: Women who skip even a previous mammogram screening before being diagnosed with breast cancer are at significantly higher risk. higher to die.
In fact, the risk of developing fatal breast cancer within 10 years of diagnosis was 50% lower for women who had regular breast screening, according to the study.