• People living with breast cancer should get vaccinated against COVID-19 when they are eligible.
• Adverse interactions have not been observed between the COVID-19 vaccines and any treatments used for breast cancer.
• New guidance advises women to time their mammograms around the COVID-19 vaccine due to the possibility of the vaccination causing enlarged lymph nodes.

Ever since the U.S. Food and Drug Administration (FDA) authorized the first COVID-19 vaccines for emergency use in December 2020, women living with breast cancer have had questions about whether these inoculations will be safe and effective for them.

On February 27, the FDA authorized the Johnson & Johnson COVID-19 vaccine for emergency use, providing a third option to the Pfizer and Moderna COVID-19 vaccines. This new vaccine requires a single dose and works in a different way than the first two vaccines. However, the FDA paused its use on April 13.

The American Cancer Society’s latest guidance states, “Many expert medical groups now recommend that most people with cancer or a history of cancer get the COVID-19 vaccine once it’s available to them.” However, many women living with breast cancer are still curious about whether they should get vaccinated.

To address these concerns, MyBCTeam sat down with Dr. Avan Armaghani. Dr. Armaghani is an oncologist in the department of breast oncology at Moffitt Cancer Center.

The COVID-19 vaccines are so new that there is not yet any specific data on results or side effects in women with breast cancer. How can we know whether they are safe and effective for this population?

Although the initial clinical trials that studied the three vaccines that are currently approved for emergency use by the FDA did not include people receiving therapies that suppress the immune system (including cancer patients actively undergoing chemotherapy), the information on the safety and efficacy data that came out of these clinical trials actually led the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) to release specific guidelines.

Those guidelines clearly recommend that all cancer patients — and cancer survivors as well — should receive the COVID-19 vaccine when they are eligible to receive it. And I believe much of that guidance stems from the fact that cancer patients, especially those who are undergoing active treatment, are at a much higher risk for complications if they do contract COVID-19.

When we weigh the benefits and risks of the vaccination, the benefits of having some immunity and defense from this virus far outweigh any potential risks of receiving the vaccine. The vaccination definitely gives people that level of protection against the potential serious and life-threatening complications that could result if they were to contract COVID-19.

Can treatments for breast cancer cause interactions with or impact the effectiveness of the vaccinations? For instance, biologics like Herceptin (trastuzumab), PARP inhibitors such as Lynparza (olaparib), chemotherapy, or hormone therapy?

We don't have any data to suggest that there are any adverse interactions between the COVID-19 vaccines and any treatments that are used for breast cancer.

That includes conventional chemotherapy treatments, targeted treatments like Herceptin, PARP inhibitors, or even immunotherapy. The National Comprehensive Cancer Network specifically says that patients who are receiving chemotherapy, immunotherapy, or any other active treatments are able to receive the COVID-19 vaccine.

Does it matter whether someone is in remission or actively treating their breast cancer in terms of timing the vaccine?

It doesn't matter. Any cancer patient, whether they're receiving active treatment, in remission, or they’re cancer survivors — they're all recommended to receive the COVID-19 vaccine.

If someone experienced a bad reaction following a flu vaccine in the past, should they also be cautious about getting the COVID-19 vaccine?

I believe that's certainly a discussion to have with your doctor. We do know that the guidelines say that if you have contraindications to any of the ingredients in any of the COVID-19 vaccines, that we do not recommend that you take the vaccine.

Talk to your doctor, and let them know what kind of reaction you had to the flu vaccine, and after the discussion, you can make a decision with your doctor about whether or not to take the vaccine.

There have been reports that the COVID-19 vaccine has caused people to get swollen lymph nodes, which is also a sign of breast cancer. Should women with breast cancer be concerned about this possible side effect of the vaccine?

This is a very interesting phenomenon and was first reported at the beginning of this year. The Society of Breast Imaging has put out a set of guidelines to address it: If you are thinking about scheduling your screening mammogram, the recommendations are to either do it before your first dose of your COVID-19 vaccine, or four to six weeks after your second dose.

Let's say you received a COVID-19 vaccine within the preceding four weeks of getting your mammogram, and you are found to have enlarged lymph nodes on the same side as the side where you received your vaccine, but the rest of the mammogram is normal. The first thing that we do is rule out any other possible causes of enlarged lymph nodes, and then typically, the recommendations are to repeat that imaging four to 12 weeks after your second dose.

That's certainly something to keep in mind and definitely not something to be alarmed about. Certainly in my practice, I have seen this very commonly now with the COVID-19 vaccine being rolled out, and I definitely tell my patients not to worry, and that we’ll repeat imaging at a later date.

Some MyBCTeam members have expressed worry about how quickly the COVID-19 vaccines were developed. Do you have similar concerns about the speed with which the vaccines were developed? And if not, why not?

Personally, I believe science is a beautiful thing, and there have been so many tremendous advancements in science over the years that have allowed us to be in the position that we are today: To develop these safe and effective vaccines in a short amount of time. So I tell my patients, “Take the vaccine.”

And this is the beauty of science — all of the scientists, researchers, and volunteers for those clinical trials have made this happen, and it really is a testament to how far we have come. I think this is really promising for what the future holds for science.

Talk With Others Who Understand

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