The COVID-19 pandemic affected breast imaging practices across the U.S., but imagers are doing their part to catch up on delayed screenings as vaccine distribution continues, according to panelists at the June 9 virtual meeting of the Society of Breast Imaging's Summer Series.
"It's been a roller coaster experience, but we're definitely in the recovery stage," said Dr. Katia Dodelzon from Weill Cornell Medical College in New York City.
Experts said their respective health systems are working to catch up on missed and delayed breast screenings from 2020. The distribution of vaccines for COVID-19 has raised questions of whether patients should delay their screening appointments.
"Absolutely not," said Dr. Pauline Germaine from Cooper Hospital in New Jersey.
"If it's only a week, maybe you should do the mammogram before you get the vaccine," said Dr. Zi Zhang from the University of Pennsylvania.
Dr. Nina Vincoff from Northwell Health said while women's imaging centers shut down from March to May 2020, screening volumes were on pace for catching up.
"We would normally do, in our health system, 87,000 screening mammograms a year," Vincoff said. "In 2020, we did 77,000, which doesn't sound so bad. Except, it's 10,000 people, which means it's 50 cancers probably that were not picked up on screening mammography last year."
For scheduling, experts said while getting the vaccine and screening mammography are both important, facilities that are catching up on delayed screenings may not have the capacity to be flexible in scheduling around the vaccine. However, they also said mammograms should not be further delayed.
"The bottom line is to get both whenever you can. If there's flexibility, we can talk more about that," Dodelzon said.
Swollen lymph nodes and other phenomena have been reported by patients after receiving the vaccine. However, experts said these symptoms indicate that the vaccine is working to develop immunity against the coronavirus. Still, they recommend people come in to examine the swollen glands, and if the swelling does not go away after about three months, they should come back for further evaluation.
Zhang said one of her patients came in with a lump under her arm, thinking it was caused by the vaccine.
"It was actually lymphoma," Zhang said. "It was probably there for a while, but maybe after getting the vaccine, she started feeling more pain. We have to get the message across that people shouldn't assume everything is because of the COVID vaccine, and if you do have symptoms, do come in."
Panelists said that delaying breast screening appointments because of concerns about the vaccine "defeats the purpose" of screening mammography.
"One in 8 women will be diagnosed with breast cancer. You want to catch it, diagnose it when it's small, and treat it so you can move on with your life," Dodelzon said.
"We're well equipped to deal with all of this. We've incorporated into our routine questionnaires questions about the vaccine, so we're aware of what patients are getting and know what side [of the arm] they're getting it in," Germaine said. "We're proactive and are responding to what's going on around us."
