Several peer-reviewed literature and radiology societies have been sounding alarms that COVID-19 vaccines can cause temporary inflammation and swelling of lymph nodes in some patients. While this is normal, according to experts, it can be a massive cause of concern for radiologists who assume it’s a sign of infection or cancer.

When lymph nodes are abnormal in size or consistency, lymphadenopathy (also called adenopathy) occurs. It commonly produces swollen or enlarged lymph nodes and is causing alarm on mammograms of recently vaccinated women. Patients who undergo CT scans can also exhibit these swollen lymph nodes.

The swollen lymph nodes that result from being vaccinated for COVID-19 are signs that the body’s immune system is gearing up in response to the vaccine. Experts say the inflammatory response will eventually go away. The same reactions have been seen in other vaccines such as human papillomavirus and influenza.

The Radiological Society of North America (RSNA) journal Radiology: Imaging Cancer published an editorial on April 9 that addresses the concerns and diagnostic dilemma. The authors point out that widespread patient education is necessary. Side-effects such as swelling should be emphasized and normalized as an immune response initiated by the vaccine.

“We write this editorial as a public service message at a time where other countries are starting mass vaccinations programs with the goal of preventing unnecessary nodal biopsies and alleviating patient concern. Imaging studies, clinicians, and news media outlets should spread awareness to educate the public regarding this side-effect to minimize patient anxiety,” the report states.

Recommendations are in place which suggest women should be asked if they have received a COVID-19 vaccine prior to imaging exams. The Society of Breast Imaging (SBI) swiftly issued recommendations for how long to wait before imaging women who receive the vaccine.

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