Before the mammographer conducted the annual squish-the-breast test, she asked me the perfunctory questions that we can all answer in our sleep. But this time, there was a new round, all of which had to do with Covid19. Had I been sick? Had anyone in my family been ill? Had I been vaccinated? (Yes, I said. I've had both of my shots.) Well, she said, we have to tell all of our patients that there is a chance of a reaction. Okay, I said, I know about the sore arm and maybe even a rash. No, she said. This is something else.
Something else? A sore arm or even a rash were side effects that have been widely publicized. But apparently, there is another wrinkle. A certain percentage of women develop a swollen lymph node (nodes) under their armpit --usually the side where they've had the shot. And? I said. Well, she said, a mammogram will pick that up, and you may be asked to return for an ultrasound.
Was she serious? Now, in most cases, she continued, there is nothing to worry about, she said. But because swollen lymph nodes can be a sign of cancer, we have to check it out. That's why we are recommending that women wait four to six weeks after their second dose of the vaccine before having a mammogram.
That's great, just great. In all the news about the vaccines, I'd never heard a word about swollen lymph nodes. I instinctively reached under my left armpit. Thankfully, nothing there--not even deodorant that I'd been warned not to use.
So like any good consumer, I sat in my car after my mammogram and googled "Swollen Lymph Nodes and Covid Vaccine." And lookie here: An article just the other day in the New York Times. "A Covid Vaccine Side Effect, Enlarged Lymph Nodes, Can Be Mistaken for Cancer." We women have been beaten over the head and urged to check our breasts and lymph nodes every month. Imagine our panic when any of us follows the advice and finds a lump. Or imagine the panic if any of us gets a call from the Imaging Department that we need to come back in because there are white blobs on the mammogram. Oh, and by the way, these white blobs resemble images that can indicate the spread of cancer!
Dr. Constance D. Lehman has made it a policy to send the following to any patient of hers who has recently had a mammogram and received the dreaded letter.
“The lymph nodes in your armpit area that we see on your mammogram are larger on the side where you had your recent Covid-19 vaccine. Enlarged lymph nodes are common after the Covid-19 vaccine and are your body’s normal reaction to the vaccine. However, if you feel a lump in your armpit that lasts for more than six weeks after your vaccination, you should let your health care provider know.”
That's a start. But what about a national PSA campaign so that those women who discover large lymph nodes don't freak out and run to get recommendations for a good oncologist?
I opened my mail today, and there was the letter. I ripped it open and fully expected that those white blobs had been found and that, unlike Dr. Lehman, I'd been notified to make a second appointment. I've had maybe thirty or more mammograms in my lifetime, but it never fails that my heart starts racing the moment I see the return address. This time, it raced a bit faster.
Happily, I was given the all-clear sign and don't have to get my drooping breasts squished again for another year. But I'm certain that there will be hundreds, probably thousands of women, who will not have heard about swollen lymph nodes and the Covid19 vaccine, who will schedule their mammogram not long after their shot instead of waiting six weeks and will go through many a sleepless night.
Spread the word. Let any female over the age of forty know what's up. (Do we start getting mammograms at forty? I can't remember.) Check out the New York Times article for more information. https://www.nytimes.com/2021/03/01/health/covid-vaccine-lymph-nodes.html
And for Pete's sake (Who is Pete, anyway?), don't decide to skip your mammogram this year. It's a matter of health and a good excuse to get out the house.