HJAR May/Jun 2021

As we move into year two of the coronavirus pandemic, the health impact it has on the patients we treat continues to evolve. Although the financial impact has been dire, some industries have been able to pause, or pivot, during the pandemic with little to no impact on the customers they serve. Oncology is not one of those. Cancer doesn’t stop for a pandemic, and neither can we. We have all had to adapt our practices and techniques to continue providing patients with the highest level of care. That is why we felt it important to reflect on how the disease, and its vaccines, have impacted the ways in which we provide care to our most vulnerable patient population. It has recently come to attention that some women may develop swollen lymph nodes under the arm after receiving the Moderna and Pfizer-BioNTech COVID-19 vaccines. The enlarged lymph nodes may be palpable, tender or detected asymptomati- cally onmammograms. While swollen lymph nodes with an otherwise normal screening mammogram is a rare occurrence, report- ed in only 0.02%-0.04% of screening mam- mograms, higher rates of enlarged lymph nodes are being reported on mammograms in women following COVID vaccination. With more than 20% of Arkansans being fully vaccinated, it is important that women understand this is a normal immune re- sponse to a vaccine, and the lymph nodes should return to normal within a few days or weeks. To reduce the chance of swollen lymph nodes appearing on a screening mammo- gram after receiving a COVID vaccination, the Society of Breast Imaging suggests pa- tients consider scheduling their screening mammogram before their first COVID vac- cine dose or 4-6 weeks after the second dose if, and only if, it does not unduly delay care. If patients are experiencing a breast prob- lem or concern, it is important that they do not delay their mammogram appointment. Patients may also not want to delay their screening mammogram appointment if they are overdue for their yearly mammogram or deferred having their screening mammo- gram last year due to the pandemic. The Breast Center at CARTI has updated our patient questionnaire to include whether the patient has received any recent vacci- nations, when it was administered and the location of the injection. This information helps us as we interpret breast imaging stud- ies such as mammograms, ultrasounds and MRIs. BREAST IMAGING STACY SMITH-FOLEY, MD, BREAST IMAGING SPECIALIST, AND JESSICA MCELREATH, MD, BREAST IMAGING SPECIALIST Stacy Smith-Foley, MD Smith-Foleycompleteda fellowship inbreast imagingatthe University ofWashington in Seattle,Washington,and com- pleted a residency in radiology at the University ofTennes- see Memorial Medical Center in Knoxville,Tennessee.She earned her medical degree from the University of Medical Sciences in Little Rock,Arkansas. Jessica McElreath, MD McElreath completed a fellowship in breast imaging and residency indiagnosticradiologyattheUniversityofMedical Sciences in Little Rock,Arkansas,where she also received her medical degree. CANCER IN THE WAKE OF COVID 18 MAY / JUN 2021 I  HEALTHCARE JOURNAL OF ARKANSAS