Harmless vaccine side effect could mimic cancer in mammograms

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One consequence of an active immune response can be an enlarged lymph node. And, because coronavirus vaccines activate the immune system, some people have swollen nodes in the days following a vaccine.

These are harmless if uncomfortable side effects – but they can be misleading when scanned by a radiologist, including during a mammogram. Here’s why.

What is this side effect?

After vaccination, a swollen lymph node may appear as a lump in the armpit. These glands are hotbeds of immune activity, filtering pathogens and storing germ-fighting cells. If you’ve had a sore throat or a cold, there’s a chance you’ve felt a swollen node in your neck. The post-vaccine node may be palpable, too.

This side effect appears to be more common after the Moderna and Pfizer shots than after the Johnson & Johnson vaccine. In Moderna’s trials, about one in six recipients reported swelling or tenderness in armpit lymph nodes, often on the same side as the shot, after a second dose.

Any swelling should resolve within days, and if it does, it isn’t a cause for concern. However, should it persist for multiple weeks, then it’s not a bad idea to notify your doctor.

Can a vaccine affect a mammogram?

Because armpits are captured in mammograms, swollen nodes may appear as alarming white spots on the images. It’s not possible for radiologists to discern the origin of the swelling – raising the possibility that they could be mistaken for metastasized cancer, which is what happened in five case reports published last month in the journal Radiology.

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