Routine mammograms and COVID-19 vaccines should be timed out carefully to prevent unnecessary anxiety, say radiologists
When it comes to COVID-19 vaccines there's been so much to wrap our heads around, and that includes the need to constantly consult our calendars.
When can I sign up? When can I get my second dose? How many weeks delay is that?
But now that the campaign is picking up speed in Quebec, some Montreal doctors want to make sure women know there’s also a timing issue when it comes to getting the vaccine and scheduling a routine mammogram.
The Canadian Association of Radiologists advises women to schedule their regular screening mammogram either before they get a dose of the vaccine or six weeks afterward.
“I think the word is slowly getting out there,” said Dr. Gabrielle Cassir, an obstetrician-gynecologist at St-Mary’s Hospital in Montreal.
She hears from patients that when they call a clinic to make an appointment, the receptionist now asks them when they got their vaccine, Cassir said.
But that has caused some concern, she said, with “patients wondering why they are asking me this question, what should I be doing?”
FALSE POSITIVES
A few months ago specialists observed that particularly with the mRNA Pfizer and Moderna products, the vaccines can cause swelling in the lymph nodes under the arm that received the injection.
“It is a very common reaction to have a temporary enlargement of lymph nodes, a common immune response to the vaccine,” Cassir said, though it doesn’t happen to everyone.
But if the lymph nodes do swell post-vaccine and sore lumps develop under the arm, it can create a “confusing picture,” says St. Mary’s Hospital radiologist Dr. Sagi Kaduri who regularly interprets mammogram results.
“In the case where the lymph nodes are enlarged, we would see them on the image as being like a small mass basically in the area of the armpit. It does stand out to you visually right away,” Kadoury said.
If the radiologist doesn’t know the patient was recently vaccinated, they would consider the swelling a concerning finding that warrants further investigation, and patients would be referred to their family doctor for an ultrasound, or even a more invasive procedure.
Earlier this spring, experts at Duke University School of Medicine in the United States heard about women who were undergoing unnecessary biopsies as a result, and they stepped in to advocate on their behalf.
“So getting the word out is [important] to try and really avoid unnecessary callbacks, tests, anxiety, and stress,” said Cassir, especially when the situation can be easily managed with proper scheduling.
Even knowing ahead of time that the woman having a screening mammogram got a vaccine a short time before the mammogram can create unwarranted concern.
“You could consider that the lymph nodes may be secondary to the vaccine, but you don't know 100 per cent that that's the case,” Kaduri said, adding “it does happen to colleagues,” who then have to ensure proper follow-up.
Both doctors emphasize a woman should not delay getting a diagnostic assessment for any possible breast cancer symptoms that need investigating regardless of the timing of a COVID-19 vaccine.
A complete list of breast cancer symptoms can be found on the Canadian Cancer Society’s website and include a lump in the armpit, changes in the shape or size of the breast, and changes to the nipple.
WHAT IF SOMEONE HAS OR HAD CANCER?
If someone is eligible to get a COVID-19 vaccine but has already been diagnosed with breast cancer, melanoma, or any cancer that can spread to the axilla (armpit), Kaduri says it’s a good idea to get the vaccine in the arm on the unaffected side of the body - again just to prevent any confusion.
The other option suggested by the Canadian Association of radiologists is to choose to get the vaccine injected into the thigh.
Cassir said it’s “an important discussion to have,” with her routine gynecology patients during this still unusual pandemic time when every day brings new science and sometimes new stress.
CTVNews.ca Top Stories
Widow looking for answers after Quebec man dies in Texas Ironman competition
The widow of a Quebec man who died competing in an Ironman competition is looking for answers.
Amid concerns over 'collateral damage' Trudeau, Freeland defend capital gains tax change
Facing pushback from physicians and businesspeople over the coming increase to the capital gains inclusion rate, Prime Minister Justin Trudeau and his deputy Chrystia Freeland are standing by their plan to target Canada's highest earners.
Tom Mulcair: Park littered with trash after 'pilot project' is perfect symbol of Trudeau governance
Former NDP leader Tom Mulcair says that what's happening now in a trash-littered federal park in Quebec is a perfect metaphor for how the Trudeau government runs things.
U.S. Senate overwhelmingly passes aid for Ukraine, Israel and Taiwan with big bipartisan vote
The U.S. Senate has passed US$95 billion in war aid to Ukraine, Israel and Taiwan, sending the legislation to President Joe Biden after months of delays and contentious debate over how involved the United States should be in foreign wars.
Wildfire southwest of Peace River spurs evacuation order
People living near a wildfire burning about 15 kilometres southwest of Peace River are being told to evacuate their homes.
World seeing near breakdown of international law amid wars in Gaza and Ukraine, Amnesty says
The world is seeing a near breakdown of international law amid flagrant rule-breaking in Gaza and Ukraine, multiplying armed conflicts, the rise of authoritarianism and huge rights violations in Sudan, Ethiopia and Myanmar, Amnesty International warned Wednesday as it published its annual report.
Train derailed in Sarnia after colliding with a truck
Police are investigating after a transport truck collided with a train in Sarnia.
Fewer medical students going into family medicine contributing to doctor shortage
As some family doctors are retiring and others are moving away from family medicine, there are fewer medical students to take their place.
'It's discriminatory': Individuals refused entry to Ontario legislature for wearing keffiyeh
Individuals being barred from entering Ontario’s legislature while wearing a keffiyeh say the garment is part of their cultural identity— and the only ones making it political are the politicians banning it.