The importance of resuming mammography

As we emerge from the devastating aftermath of the COVID-19 pandemic, resuming screening examinations such as mammography must be a priority. Last March, as COVID raged across our state, little was known about how the virus spread, and what precautions would keep us safe. We learned that although highly contagious, COVID is not spread by touching surfaces, but rather by aerosolized particles. Mask wearing, social distancing and avoiding large crowds would prove to be the most effective public health measures to decrease transmission. Today, with the several effective vaccines available for most adults in Connecticut, there seems to be a light at the end of this tunnel.

Mammography departments in our community and others have taken extraordinary measures to ensure safety of patients. These include staggered appointments, expanded hours, frequent cleaning and sterilization of equipment between tests, expanded night and weekend hours, mandatory mask wearing, and social distancing to name a few. We encourage all women not to delay breast imaging, particularly those at high risk.

In late spring of 2020, screening mammography decreased dramatically across the U.S. Emerging data suggest that patients who went undiagnosed during this time were subsequently diagnosed with more advanced breast cancer- larger tumors, breast cancer in their lymph nodes, and/or breast cancer that had spread to other parts of the body. This findings reinforces the value of screening and the need to catch up now.

Screening mammography is often able to detect breast cancer before it is clinically apparent, and has been shown in several large studies to save lives. When diagnosed at an early stage, breast cancer is usually curable and treatment de-escalation can be discussed for select patients.

The COVID vaccine may cause the lymph nodes in the armpit (axilla) to become enlarged, as the immune system reacts, but palpable lymph nodes may also be a sign of breast cancer. It is recommended that mammography be performed before vaccination if possible. If enlarged nodes are seen on mammogram or ultrasound after the COVID vaccine, it is important to follow up with another test six to eight weeks later to make sure the nodes decrease in size. Women with clinical signs of breast cancer including a palpable mass, skin changes, breast swelling, etc. should undergo a breast imaging workup.

If you or someone you love is due for breast imaging please do not hesitate to schedule your exam or schedule an appointment with a breast surgeon for evaluation.

Dr. Brigid K. Killelea, Dr. Richard S. Zelkowitz, Dr. Kelly A. Harkins, Dr. Michele Even Hartford HealthCare