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COVID-19 Vaccines and Inflammatory Unilateral Axillary Adenopathy

Why do some folks think that COVID-19 vaccines are causing some recipients to develop inflammatory unilateral axillary adenopathy?

COVID-19 vaccines are causing some people to develop swollen glands in their armpit area.

Because they actually are!

COVID-19 Vaccines and Inflammatory Unilateral Axillary Adenopathy

Does that sound scary?

It simply means that some people are developing swollen glands in their armpit area after getting vaccinated…

Why?

This type of reactive lymphadenopathy is common after both vaccination and natural infections. Vaccine antigens trigger an immune response that eventually lead to the closest draining lymph nodes, where T and B lymphocytes are activated.

For a shot in the arm, those draining lymph nodes are mostly in your arm pit area.

Lymph nodes are small bean-shaped glandular nodules.

So what’s the problem?

Normally it wouldn’t be a big deal, as the axillary adenopathy goes away on its own, without treatment, typically in about four to six weeks.

“Reports of patients with axillary adenopathy identified on breast imaging after coronavirus disease (COVID-19) vaccination are rising.”

Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach

But the axillary adenopathy is showing up when some recently vaccinated women get their mammograms.

“We present five cases of axillary lymphadenopathy which occurred after COVID-19 vaccination and that mimicked metastasis in oncologic patients. Initial radiologic diagnosis raised concerns for metastasis.”

Lymphadenopathy in COVID-19 Vaccine Recipients: Diagnostic Dilemma in Oncology Patients

And if they don’t know about the connection between a recent COVID-19 vaccination and axillary lymphadenopathy, it might lead the health care provider and patient to think that something much more serious is going on.

“The lymph nodes in the underarm are called axillary lymph nodes. If breast cancer spreads, this is the first place it’s likely to go.”

Lymphatic system and axillary nodes

Fortunately, raised awareness has led to new protocols that will hopefully avoid anyone getting unnecessary testing done just because they have axillary adenopathy after getting their COVID-19 vaccine.

“For patients with palpable axillary adenopathy in the setting of ipsilateral recent vaccination, clinical follow-up of the axilla is recommended. In all these scenarios, axillary ultrasound is recommended if clinical concern persists six weeks after vaccination. In patients with recent breast cancer diagnosis in the pre- or peri-treatment setting, prompt recommended imaging is encouraged as well as vaccination (in the thigh or contralateral arm).”

Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach

Can’t you just put off getting your mammogram? Make sure it is at least 6 weeks after you are completely vaccinated? Or put off getting your COVID-19 vaccine if your mammogram is already scheduled?

“In this setting, we believe our model can avoid reducing or delaying vaccinations and avoid further reduced or delayed breast cancer diagnoses based on confusion amongst patients and/or their providers.”

Mitigating the Impact of Coronavirus Disease (COVID-19) Vaccinations on Patients Undergoing Breast Imaging Examinations: A Pragmatic Approach

Talk to your health care provider, but in general, there are risks to delaying your mammogram, just as there are risks to delaying getting a COVID-19 vaccine if you are eligible and it is available.

“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.”

SBI Recommendations for the Management of Axillary Adenopathy in Patients with Recent COVID-19 Vaccination

Still, scheduling your mammogram around your COVID-19 vaccine could be an option if it doesn’t “unduly delay care.”

More on COVID-19 Safety Update

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