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Intermountain Healthcare: COVID-19 vaccine changes mammogram guidelines

Mammography is recommended yearly for all healthy women over the age of 40. Photo: Getty Images

MURRAY, Utah — As COVID-19 vaccinations continue across Utah, Intermountain Healthcare is changing its mammogram guidelines for women getting the vaccine. 

The new guidelines are recommended nationwide by the Society of Breast Imaging and include delaying annual mammograms for those getting screened, who have recently received one or more doses of COVID-19 vaccine.

New recommendations for mammogram and COVID-19 vaccine

Dr. Brett Parkinson, medical director of Intermountain Healthcare’s Breast Care Center, says those new guidelines include waiting four to six weeks after the second vaccination before getting a mammogram.  Dr. Parkinson says the reason for this is there could be false positives that show up in screenings due to inflammation resulting from the vaccination.

“When one gets a vaccination, there is an inflammatory response in the arm.  That inflammation is manifested in large lymph  nodes in the arm pit area. Ordinarily, we don’t see enlarged lymph nodes on a mammogram or other imaging study unless there is severe pathology either from inflammation or malignancy,” Parkinson said.

He says when you have a mammogram right after a COVID vaccine, you can have enlarged lymph nodes.  With the Moderna vaccine, it’s about 11% after the first dose, 16% after the second dose. 

How inflammation may affect mammograms

In a mammogram, according to Dr. Parkinson, elevated numbers on a normal screening could show false positives, such as metastatic breast cancer which has traveled to the lymph nodes, or lymphoma or leukemia.  He says in order to prevent such inaccuracies, a waiting period is necessary.

“We, early on, decided a few weeks ago that we were going to institute a policy whereby we would encourage patients to get their mammogram screening either before their first vaccine or they wait four weeks after the second vaccine, so the symptoms of swollen lymph nodes could subside,” noted Parkinson.

He says in normal settings,  swollen or enlarged lymph nodes can represent serious conditions or disease. Infections can also cause inflammation that would trigger a false positive result, but Parkinson says the COVID-19 vaccine causes much more severe inflammatory response, seen in about 10 to 15% of patients. 

Even if a patient plans to get just one dose of the vaccine, Parkinson recommends waiting four-to-six weeks before getting a mammogram. 

Parkinson advises against putting off a mammogram for an extended period of time, or even canceling the yearly check-up altogether.

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