Why COVID-19 vaccines raise false red flags of breast cancer – National

A particular side effect of COVID-19 vaccines is raising false red flags for some women in Canada and elsewhere, leading them to believe they may have breast cancer.

As a normal side effect for most vaccines, the axillary lymph nodes in the area of ​​the pit where the vaccination took place may temporarily swell or widen – a sign that the vaccine works by mounting an immune response. This is called unilateral axillary lymphadenopathy (UAL).

Although the reaction is not unusual, COVID-19 vaccines are reported to have higher rates of UAL than normal and are confused with a potential symptom of breast cancer.

“The rate of enlargement is more frequent compared to other vaccinations,” said Dr. Sandeep Ghai, head of the breast imaging division at the University Health Network, Sinai Health and Women College Hospital.

“Naturally there is panic and fear among women,” she added.

Enlarged lymph nodes when seen on a mammogram are also a sign of leukemia and lymphoma.

The lymph nodes become fragile and swell within two to four days of vaccinating COVID-19, and the swelling can last up to six to eight weeks.

“There are certainly more immune system reactions to this type of vaccine than some of the other vaccines our bodies have seen before, so I think that’s an explanation for why the lymph nodes are so visible after this. vaccine, ”says Dr. Lisa Mullen, assistant professor of radiology at Johns Hopkins Medicine, said.

Some women may feel the lump, but for others, the swelling is only detected during a mammogram, which involves an X-ray image of the breasts.

It is a trend radiologists in Canada and across the border in the United States are beginning to see more and more as vaccines continue to unfold.

“Every week we see one or two patients, either on routine mammograms or on someone who sees the knot and wine,” Ghai told Global News.

At Ottawa Hospital, Dr. Jean Seely, head of the breast imaging department, says she has seen at least four such cases of women with enlarged lymph nodes who came for a breast exam after receiving a COVID-19 vaccine.

“It’s not alarming, but it’s something we need to be aware of, because it can be confused with breast cancer if we don’t have that history of vaccination.”

As a protocol to avoid confusion, women who come for a breast exam are asked if they have recently received the COVID-19 vaccine.

“If there is a history of vaccination within six weeks of mammography or armpit swelling, we recommend that women be examined by their doctors to make sure the swelling goes away within six weeks,” said Seely, who is also the president of the Canadian Society. breast imaging, said.

But if the clinical symptoms persist for more than six weeks after vaccination, an axillary ultrasound is recommended for further evaluation.

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In the US, about 11 percent of people in the 18-64 age group who received the Moderna vaccine had swollen lymph nodes after the first dose and 16 percent after the second shot, according to the Centers for Disease Control and Prevention (CDC). Such cases have also been reported for the Pfizer-BioNTech vaccine.

Dr. Connie Lehman, director of breast imaging at Massachusetts General Hospital in Boston, has rejected any fears about a correlation between COVID-19 vaccines and breast cancer.

“Vaccinations do not cause breast cancer. It does not cause lymph node cancer. ”

Despite the similarities between the symptoms, Lehman said a clear distinction can easily be made between the two.

“The signs of breast cancer are so different than the signs of unilateral swollen lymph nodes after a COVID vaccine, so it’s not a diagnostic dilemma and we feel we can do very well,” she said.

Breast cancers are presented as calcifications (calcium deposits), sprains and masses in the breast, while the swollen lymph nodes after vaccination are only in the area of ​​the pit of the arms, Lehman explained.

Mullen said the breast tissue itself does not change in response to the vaccine.

“The pathologist will actually see breast cancer cells in the lymph nodes, so we can differentiate in those few patients where it is crucial to differentiate,” she told Global News.

But we don’t want to recommend biopsies for normal lymph nodes, which are only bigger because they process the vaccine.

To avoid confusion, the Canadian Breast Imaging Society and the Canadian Association of Radiologists recommend, where possible, consider scheduling screening tests before the first dose or six weeks after each dose in patients at medium risk.

Women who are overwhelmed for screening due to pandemic delays or are symptomatic should switch to mammography, regardless of when the vaccination dose is given, say updated guidelines in March.

In a statement to Global News, Health Canada said: “We encourage women to discuss mammography appointments with their doctors, who will be best advised in the light of their medical history.”

Meanwhile, the US Society of Breast Imaging suggests a four- to six-week wait for breast screening after the second dose.

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If women have a personal history of breast cancer or are undergoing treatment for breast cancer, Collen advised getting vaccinated on the opposite side of their body.

In any case, breast imaging experts and radiologists are not in favor of women who delay a COVID-19 vaccine or postpone their mammography appointments.

“I really think it’s very important for women to be screened and vaccinated,” Seeley said.

The other experts agreed.

“We don’t want this to discourage women from getting vaccinated,” Lehman said.

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