COVID-19 Vaccine-Related Adenopathy

This communication provides updated guidance from the Carol Milgard Breast Center (CMBC) regarding scheduling a screening mammogram or breast MRI during COVID-19 vaccination.

Background: There has been a reported increase in axillary lymphadenopathy following administration of the COVID-19 vaccination. To minimize unnecessary callbacks from screening mammograms, we recommend the following, as advocated by the Society of Breast Imaging (SBI):

SBI considerations for patients and providers scheduling a screening mammogram or breast MRI —

• If possible, and when it does not unduly delay care, consider scheduling screening exams prior to the first dose of a COVID-19 vaccination or 4-6 weeks following the second dose of a COVID-19 vaccination.

The following guidelines will be followed by CMBC for the management of axillary adenopathy in patients with recent COVID-19 vaccination:

• The CMBC patient intake process will include questions regarding COVID-19 vaccination. To minimize patient anxiety, staff will start with the following introductory statement: Vaccines of all types can result in temporary swelling of the lymph nodes, which may be a sign that the body is making antibodies in response as intended.
• Enlarged lymph nodes seen on screening mammography will be given a BI-RADS 0 assessment.
• If there is a history of recent Covid-19 vaccination, further diagnostic imaging will be delayed 4-6 weeks after the second or last vaccine dose. Most lymphadenopathy associated with vaccination will resolve during this time.
• If lymphadenopathy persists after follow-up imaging, percutaneous sampling will be performed to rule out malignancy.
• If lymphadenopathy is found on clinical exam and there is a history of recent Covid-19 vaccination, consider delaying imaging evaluation until 4-6 weeks after the second or last dose as most lymphadenopathy will resolve during this time.

If you have any questions, please call 253.759.2622 to speak to our team.