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Typhoid Fever: Symptoms, Causes, Treatments


What is typhoid fever?

Typhoid fever is a bacterial infection that can be life-threatening. Most cases of typhoid fever occur in developing nations. However, the disease can occur anywhere, including industrialized countries like the U.S.

Who is most at risk for getting typhoid fever?

Individuals are most at risk for the disease in developing nations where good sanitation is lacking and people have limited access to clean water and safe foods. These areas are primarily in parts of Asia, Central and South America, Africa, and the Caribbean. Typhoid fever is less common in industrialized nations like the U.S. Most cases of typhoid fever in developed countries occur in returning travelers who can spread the illness to others or in contaminated foods. It is estimated that approximately 5,700 cases occur each year in the U.S. (but only 400 are confirmed).

Symptoms and Causes

What causes typhoid fever?

The bacterium Salmonella typhi (S. typhi) causes typhoid fever. The bacteria spreads through contaminated food, drink, or water. People infected with Salmonella typhi carry the bacteria in their intestinal tract and blood.

Salmonella typhi is shed (discarded from the body) in feces (stool). You may get typhoid fever if you ingest food or beverages prepared by someone who is shedding the bacteria and who does not wash their hands properly. In less developed countries, sewage containing Salmonella typhi may contaminate local water supplies.

In some cases, people who have previously had typhoid fever still carry Salmonella typhi bacteria. These people are carriers of the disease. They may spread the infection even when they have no symptoms (the famous case of “Typhoid Mary” in the U.S.).

What are the symptoms of typhoid fever?

In early stages of the disease, symptoms include: abdominal pain, fever, and a general feeling of being unwell. These initial symptoms are similar to other illnesses.

As typhoid fever gets worse, symptoms often include:

  • High fever of up to 104 degrees Fahrenheit
  • Headaches
  • Abdominal pain, constipation then perhaps diarrhea later
  • Small, red spots on your abdomen or chest (rose-colored spots)
  • Loss of appetite and weakness

Other symptoms of typhoid fever include:

  • Body aches
  • Bloody stools
  • Chills
  • Severe fatigue
  • Difficulty paying attention
  • Agitation, confusion, and hallucinations (seeing or hearing things that are not real)

Diagnosis and Tests

How is typhoid fever diagnosed?

Doctors use a simple blood or stool test to diagnose typhoid fever. This test identifies the presence of Salmonella typhi in blood or stool samples.

In the U.S., doctors may not consider typhoid fever at first because it is uncommon. It’s important to tell your doctor if you have traveled to an area where typhoid fever could be present or if you think you’ve been exposed to someone who could have the infection.

Management and Treatment

How is typhoid fever treated?

Antibiotics are used to treat typhoid fever. These medications kill the bacteria that cause the infection. Several different types of antibiotics are used to treat typhoid fever. In many cases, typhoid fever is treated with ampicillin, chloramphenicol, or cotrimoxazole (Bactrim®). However, doctors also use fluoroquinolones (including Cipro® and Levaquin®), cephalosporins (including Cefepime®), and azithromycin.

Your doctor will choose based on the most up-to-date recommendations. Antibiotics are widely available in the United States and in most other countries in the world. Do not attempt to self-treat with leftover antibiotics.

Some people need supportive therapies, such as fluid or electrolyte replacement, depending on the severity of the infection.

What complications are associated with typhoid fever?

People who do not receive treatment for typhoid fever may have symptoms of the disease for months. In those cases, complications, like kidney failure or intestinal hemorrhage (severe bleeding), are possible. In severe cases, typhoid fever is fatal if left untreated. They may also become carriers and spread the illness to others.


Can typhoid fever be prevented?

If you are traveling outside the U.S., you can lower your risk of contracting the disease by:

  • Receiving a typhoid fever vaccination. Currently, two vaccines are available to help prevent the spread of typhoid fever. Talk with your doctor about getting vaccinated.
  • Avoiding food that is raw or undercooked
  • Drinking only bottled water or water that has been boiled
  • Thoroughly washing your hands each time before eating
  • Avoiding raw fruits and vegetables that cannot be peeled.
  • Avoiding eating foods and beverages purchased from street vendors.

Outlook / Prognosis

What is the prognosis (outlook) for people with typhoid fever?

For most people who receive treatment with antibiotics, typhoid fever symptoms improve within 2 to 4 weeks. Your symptoms may return if you do not finish your entire treatment that your doctor recommends.

Living With

When should I call my doctor?

If you develop any of the symptoms of typhoid fever or your condition does not improve, contact your doctor immediately. He or she can evaluate you to determine if you are infected. If you are traveling outside the U.S. and develop any of the symptoms of typhoid fever, contact that country’s U.S. consulate for a list of recommended doctors.

Covid-19 vaccine booster: Don’t panic if you get swollen lymph nodes. But be aware if you’re due for a mammogram

Don’t panic, doctors say. Swollen lymph nodes caused by vaccination are temporary, harmless and a sign that the vaccine is working.

But to avoid unnecessary anxiety and uncertainty, women planning to get a mammogram should know that swollen lymph nodes right after a vaccine dose might show up on a mammogram, the US Food and Drug Administration’s top vaccine official said this week.

“If you are a woman, and you’re going to get a mammogram, and you get your booster shot, call and tell them you’re getting it (or) you’ve gotten it,” Dr. Peter Marks, head of the FDA’s Center for Biologics Evaluation and Research, said at a town hall hosted by the Covid-19 Vaccine Education and Equity Project.

“If you’re going to get it, you might want to get your mammogram first before you get it, or you might want to wait a couple of weeks because if those lymph nodes turn up on a mammogram, they may trigger a false, further investigation,” Marks said. “It’s really a harmless thing, except if it triggers extra medical investigation, so that’s just something to be aware of.”

To be clear: “The Covid vaccine does not cause breast cancer or increase your risk for breast cancer,” said Dr. Lisa Ann Mullen, breast imaging fellowship director and assistant professor of radiology and radiological science at Johns Hopkins Medicine. “But it can make the lymph nodes larger, and that includes (after) the booster.

Why does this happen?

After a vaccine shot to the arm, lymph nodes in the armpit area can sometimes swell as the immune system is activated and builds an army of antibodies. And those swollen lymph nodes might show up on mammograms, said Dr. Connie Lehman, chief of breast imaging at Massachusetts General Hospital and a professor of radiology at Harvard Medical School.

“We’re not surprised at all. This is an extremely effective vaccine,” Lehman told CNN on Thursday.

“It incites an immune response by the body that is necessary to fight off the Covid-19 virus, should it enter a person’s body,” Lehman said. “So these enlarged lymph nodes are evidence that the vaccine is doing exactly what our bodies need it to do.”

It’s not just Covid-19 vaccines — the flu shot, the shingles vaccine and the diphtheria/tetanus/pertussis (D-TaP) shot can also temporarily change the appearance of lymph nodes, Mullen said.

She often sees enlarged lymph nodes from the flu vaccine show up on mammograms in October.

“I wish we could move Breast Cancer Awareness Month from October to some other month, like May or June, because every year it has been flu vaccine season as well,” Mullen told CNN on Thursday. “I call back some people from screening, who I know they had a flu vaccine, and their lymph nodes are a little big.”

“And you know it’s probably because of the flu vaccine, but I can’t be 100% sure. So often we’ll ask those women to come in,” possibly for an ultrasound to investigate further, Mullen said.

So when should women coordinate vaccines and mammograms?

Women eligible for an additional dose of vaccine who also have a mammogram planned for the near future should check with their healthcare provider, said Marks, the FDA vaccine official.

Not all doctors will agree, and not all patients will have the same circumstances, Mullen said.

She said it’s important to get vaccine doses on schedule. And if your regularly scheduled mammogram is several weeks away, any vaccine-induced swollen lymph nodes probably wouldn’t be an issue, Mullen said.

If you’re due for a mammogram soon, Mullen suggests getting it. She said results are typically available within a few days, and women can get vaccinated afterward — reducing the chances of vaccine-induced swollen lymph nodes showing up on a mammogram.

But if a woman recently got vaccinated and has swollen lymph nodes, she may want to wait a few weeks before getting a mammogram, Mullen said.

“If it’s possible to do a mammogram before the Covid vaccine series, or before the booster, then that’s great. If it’s not possible, and you can wait several weeks (for a mammogram), that’s OK, too,” she said.

There’s one circumstance in which women should get examined for breast cancer immediately — regardless if they just got a shot, Mullen said.

“If this is a diagnostic situation — and by that I mean somebody has a symptom in their breast like they have a nipple discharge, they have breast pain, there’s something going on in the breast that’s different and new for them, or their doctor feels a lump . .. we want them to come right away,” she said.

“I don’t care whether they had their vaccine yesterday. Just come on in, and we’ll work on whatever the problem is,” Mullen said.

‘Don’t delay either. Get both’

Lehman said it’s important not to skip or delay mammograms — something many women have already done during the pandemic.

She encourages women to get screened for breast cancer as scheduled — even if they recently got vaccinated.

“Don’t delay either. Get both,” Lehman said. She said there are ways to help detect whether a swollen lymph node is simply the result of vaccination or something more concerning.

“There’s a very specific list we check through,” Lehman said.

“We document every single patient where their Covid vaccine was. So I see a mammogram come up, and the woman had a vaccine in her right arm, and she has asymmetrically enlarged lymph nodes in the right armpit, I put a statement in to the patient and her doctor and I say, ‘This is a normal response to the vaccine. If you have any clinical concerns, if you can feel the swelling, it gets worse, if you have any concerns, see your doctor. You can always do more evaluation,'” she said.

“Please don’t delay your mammogram, and please don’t delay your vaccination.”

CNN’s Virginia Langmaid and Sandee LaMotte contributed to this report.

Armpit Lump | 10 Possible Causes for Lumps in the Armpit

Skin abscess

A skin abscess is a large pocket of pus that has formed just beneath the skin. It is caused by bacteria getting under the skin, usually through a small cut or scratch, and beginning to multiply. The body fights the invasion with white blood cells, which kill some of the infected tissue but form pus within the cavity that remains.

Symptoms include a large, red, swollen, painful lump of pus anywhere on the body beneath the skin. There may be fever, chills, and body aches from the infection.

If not treated, there is the risk of an abscess enlarging, spreading, and causing serious illness.

Diagnosis is made through physical examination.

A small abscess may heal on its own, through the body’s immune system. But some will need to be drained or lanced in a medical provider’s office so that the pus can be cleaned out. Antibiotics are usually prescribed.

Keeping the skin clean, and using only clean clothes and towels, will help to make sure that the abscess does not recur.

Rarity: Common

Top Symptoms: rash with bumps or blisters, red rash, red skin bump larger than 1/2 cm in diameter, pus-filled rash, rash

Symptoms that always occur with skin abscess: rash with bumps or blisters

Urgency: Primary care doctor


Lipoma is a word that translates as “fatty tumor,” but a lipoma is not cancer. It is simply a growth of fat between the muscle layer and the skin above it.

The exact cause is not known. The condition does run in families and is associated with other unusual syndromes such as adiposis dolorosa, which is similar. Lipomas most often appear after age 40.

Symptoms include a soft, easily moveable lump beneath the skin, about two inches across. A lipoma is painless unless its growth is irritating the nerves around it. They are most often found on the back, neck, and abdomen, and sometimes the arms and upper legs.

It is a good idea to have any new or unusual growth checked by a medical provider, just to make certain it is benign.

Diagnosis is made through physical examination, biopsy, and imaging such as ultrasound or CT scan.

Most of the time, treatment is not necessary unless the lipoma is unsightly or is interfering with other structures. It can be removed through surgery or liposuction.

Rarity: Uncommon

Top Symptoms: skin-colored groin bump, marble sized groin lump, small groin lump

Symptoms that always occur with lipoma: skin-colored groin bump

Urgency: Wait and watch

Boil (furuncle)

A furuncle, also called a boil, is infection of a hair follicle. The infection forms under the skin at the root of the hair and may occur anywhere on the body.

The infection is caused by bacteria, most often Staphylococcus aureus or “staph.” Irritation caused by clothes or anything else rubbing the skin can cause the skin to break down and allow bacteria to enter.

Staph bacteria are found everywhere. Frequent and thorough handwashing, and otherwise maintaining cleanliness, will help to prevent its spread.

Most susceptible are those with a weakened immune system; diabetes; and other skin infections.

Symptoms include a single bump under the skin that is swollen, painful, and red, and contains pus.

It is important to treat the boil, since infection can spread into the bloodstream and travel throughout the body.

Diagnosis is made through physical examination and sometimes fluid sample from the boil.

Treatment may involve incision and drainage of the infection, followed by creams to apply to the site of the boil and/or a course of antibiotic medicine.

Rarity: Uncommon

Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump, constant skin changes

Symptoms that always occur with boil (furuncle): pink or red facial bump

Symptoms that never occur with boil (furuncle): fever

Urgency: Self-treatment

Enlarged lymph nodes in the armpit

Enlarged lymph nodes occur when the node becomes larger as it fills with inflammatory cells. This often is a result of an infection but can occur without a known cause.

Rarity: Common

Top Symptoms: armpit lump, movable armpit lump

Symptoms that always occur with enlarged lymph nodes in the armpit: armpit lump

Symptoms that never occur with enlarged lymph nodes in the armpit: fever, unintentional weight loss, hard lump in the armpit

Urgency: Phone call or in-person visit


Pimples are also called comedones, spots, blemishes, or “zits. ” Medically, they are small skin eruptions filled with oil, dead skin cells, and bacteria.

Pimples often first start appearing at puberty, when hormones increase the production of oil in the skin and sometimes clog the pores.

Most susceptible are teenagers from about ages 13 to 17.

Symptoms include blocked pores that may appear flat and black on the surface, because the oil darkens when exposed to the air; blocked pores that appear white on the surface because they have closed over with dead skin cells; or swollen, yellow-white, pus-filled blisters surrounded by reddened skin.

Outbreaks of pimples on the skin can interfere with quality of life, making the person self-conscious about their appearance and causing pain and discomfort in the skin. A medical provider can help to manage the condition, sometimes through referral to a dermatologist.

Diagnosis is made through physical examination.

Treatment involves improving diet; keeping the skin, hair, washcloths, and towels very clean; and using over-the-counter acne remedies.

Rarity: Common

Top Symptoms: pink or red facial bump, small facial lump, painful facial bump, marble sized facial lump

Symptoms that always occur with pimple: pink or red facial bump

Urgency: Self-treatment


Folliculitis is a common skin problem where hair follicles are infected by bacteria or fungi.

Rarity: Common

Top Symptoms: small facial lump, pink or red facial bump, face itch, facial bump leaking yellow/milky fluid, yellow or white facial bump

Symptoms that always occur with folliculitis: small facial lump

Urgency: Self-treatment

Hodgkin’s lymphoma

Hodgkin lymphoma, formerly known as Hodgkin’s lymphoma or Hodgkin’s disease, is cancer of the lymphatic system. It is believed to be caused by a mutation in one of the body’s immune system cells, called a B cell.

Most susceptible are those under age 30 or over age 55, with a family history of the disease, as well as anyone with a history of any illness caused by the Epstein-Barr virus.

Symptoms include swelling of lymph nodes in groin, armpits, and neck; lowered tolerance to drinking alcohol, including pain in lymph nodes afterwards; unintended weight loss; fever; chills; night sweats; and itching.

There are good treatments available for Hodgkin lymphoma, so it is important to see a medical provider about these symptoms as soon as possible.

Diagnosis is made through physical examination; blood tests; imaging such as x-ray, CT scan, or PET scan; and sometimes lymph node biopsy and/or bone marrow sample.

Treatment involves a combination of chemotherapy and radiation therapy. Bone marrow transplant, also called stem cell transplant, can be done in some cases.

Rarity: Rare

Top Symptoms: fatigue, loss of appetite, abdominal pain (stomach ache), shortness of breath, fever

Symptoms that never occur with hodgkin’s lymphoma: pulsing armpit mass, armpit lump that comes and goes, shrinking armpit lump, pink or red armpit bump, black or brown armpit bump, yellow or white armpit bump, bleeding armpit bump

Urgency: Primary care doctor


Warts, also called common warts or verrucae, are small, rough, rounded growths on the top layer of the skin. They may appear alone or in clusters. Common warts are caused by the human papillomavirus (HPV) and are contagious through direct contact. They may spread from one place on the body to another simply through touch.

Breast cancer

There are several types of breast cancer, depending on the part of the breast where it starts. The most common types are ductal carcinoma in situ (DCIS), invasive ductal carcinoma and invasive lobular carcinoma.

Women over age 50 with a family history of the disease, and/or certain genetic factors, are most at risk, but anyone can get breast cancer at any age. It is rare in men but does occur.

Symptoms include a lump, thickening, or pain anywhere in the breast or armpit; red, flaky, or irritated breast or nipple skin; nipple discharge; and any area of irregular skin or misshapenness.

Many harmless conditions can cause similar signs, so it is important to see a medical provider about any of these symptoms.

Diagnosis is made through physical examination; imaging such as ultrasound, mammogram, or MRI; and sometimes biopsy.

Treatment involves a combination of surgery, radiation therapy, and chemotherapy.

The best prevention is a combination of screening mammograms as recommended by the medical provider, and monthly self-examination.

Rarity: Uncommon

Top Symptoms: breast pain, armpit lump, breast mass or retraction, breast lump, nipple discharge

Urgency: Primary care doctor

Can the COVID-19 Vaccine Cause Swollen Lymph Nodes? Doctors Explain

If you’ve ever experienced swollen lymph nodes, you know how uncomfortable (and temporarily concerning) their presence can be. After all, when lymph nodes—small, bean-shaped glands throughout your entire body—become enlarged, it’s typically a sign that your immune system is reacting to something it perceives as a threat.

With the COVID-19 vaccine, that “something” is a sign that your body is being primed to recognize the novel coronavirus once your immunization is complete—meaning you might experience short-lived side effects, particularly after the second dose in a two-part series. This can include arm swelling and soreness around the injection site, a mild fever, headaches, chills, and yes, even swollen lymph nodes.

In fact, the Society of Breast Imaging (SBI) issued a recommendation earlier this year that women should wait to get a mammogram after their COVID-19 vaccine because lymph node swelling in the armpit caused by the vaccine could be mistaken for breast cancer.

However, rest assured that swollen lymph nodes are just a sign that your immune system is getting to work post-vaccine, says Jamie Alan, Pharm.D., Ph.D., associate professor of pharmacology at Michigan State University.

But what do these glands look and feel like? And how long will the swelling last if you experience this annoying side effect? Ahead, experts explain what to expect.

First, a brief primer on why lymph nodes swell.

Your immune system contains a network of lymph vessels and lymph nodes. They make up your lymphatic system, which collects fluid, waste, viruses, and bacteria that travel into your tissues outside of your bloodstream, according to the American Cancer Society (ACS).

Your lymph vessels are a bit like blood vessels. But instead of blood, they contain a clear, watery fluid (a.k.a. lymph fluid). The main job of this fluid is to fight infections with the assistance of white blood cells. So basically, our lymph nodes work as filters for potentially harmful substances, the ACS says.

If you do happen to have an infection, an injury, or a disease like cancer, the nodes—say, in your neck, in your armpit, under your chin, or around your groin—can swell or enlarge as they attempt to filter the harmful stuff out of your body.

Are swollen lymph nodes a common side effect of the COVID-19 vaccine?

The SBI’s report cited data that found up to 11.6% of patients who received the Moderna COVID-19 vaccine had swollen or tender lymph nodes after the first dose, while 16% of patients experienced it after their second shot. The side effect was not as common in those who received the Pfizer-BioNTech vaccine, but it was still reported among those patients.

You can get swollen lymph nodes anywhere, but you’ll likely notice them under your arms and in your neck if they appear post-vaccine, says infectious disease expert Amesh A. Adalja, M.D., senior scholar at the Johns Hopkins Center for Health Security. “It’s usually around the areas where the injection was,” he says, and it will feel like a soft, tender lump.

It’s also important to note that this side effect isn’t unique to the COVID-19 vaccine, and can even happen with the flu shot, says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine.

Because the COVID-19 vaccine is newly developed and we’re all much more aware of potential side effects (and our health after a stressful year), we may “simply be paying more attention to our bodies,” Dr. Schaffner says, resulting in more frequent reports.

How long do swollen lymph nodes last after the COVID-19 vaccine?

The SBI’s report found that those who experienced swollen lymph nodes could have them up to 10 days post-vaccine on average. But everyone’s body is different, and the swelling can last about a week, possibly longer. “Swollen lymph nodes will usually get progressively smaller,” Dr. Adalja says.

Can you treat swollen lymph nodes?

If your swollen lymph nodes aren’t bothering you, you don’t necessarily need to treat them as they reduce in size on their own. But if you’re uncomfortable, Alan says that you can use heat on the area (think: a warm, damp washcloth). You can also take an OTC medication like acetaminophen or ibuprofen to help reduce pain and inflammation.

Of course, it’s important to keep in mind that your swollen lymph nodes might be due to something else going on in your body. If they popped up right after your vaccine, it’s very likely linked to that—but they should start to settle down in about a week or so. If they persist any longer or feel especially hard, Dr. Schaffner recommends calling your doctor. “Something else might be involved,” he says, and it’s best to get things checked out to ensure a proper diagnosis.

This article is accurate as of press time. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the novel coronavirus develops, some of the information may have changed since it was last updated. While we aim to keep all of our stories up to date, please visit online resources provided by the CDC, WHO, and your local public health department to stay informed on the latest news. Always talk to your doctor for professional medical advice.

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Korin Miller
Korin Miller is a freelance writer specializing in general wellness, sexual health and relationships, and lifestyle trends, with work appearing in Men’s Health, Women’s Health, Self, Glamour, and more.

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Underarm Lump After COVID Shot Is Likely Lymph Swelling, Not Breast Cancer, Experts Say – Consumer Health News

MONDAY, March 1, 2021 (HealthDay News) — That swollen lymph node under your arm could be a temporary side effect of a COVID-19 shot and not a sign of serious health problems.

Radiologists from Massachusetts General Hospital noticed an increase in patients with swollen underarm lymph nodes as they were doing routine mammogram screenings. So they established an approach to help prevent delays in both vaccinations and breast cancer screening.

When seen on mammograms, these vaccine-swollen nodes can be mistaken for those enlarged because of cancer. They may even lead to a biopsy.

“We had started to see more patients in our breast imaging clinic with enlarged lymph nodes on mammography, ultrasound and magnetic resonance imaging. And we noticed they were coming to our clinic after a recent COVID-19 vaccination,” said lead author Dr. Constance Lehman, chief of breast imaging and co-director of the Avon Comprehensive Breast Evaluation Center at Mass General in Boston.

“We talked with our colleagues in primary care and in our breast cancer specialty clinics and realized we needed a clear plan for management,” she said in a hospital news release.

The group’s approach is based on three principles: The first is encouraging COVID-19 vaccination. The second is reducing or eliminating delays, cancellations and rescheduling of breast imaging. The third is avoiding unnecessary extra imaging or biopsies of lymph nodes that have become swollen from recent vaccination.

Lehman and colleagues said no additional imaging is needed for swollen lymph nodes after recent vaccinations unless swelling persists or the patient has other health issues.

This message should be communicated to both imaging staff and patients, they said.

Patient letters may read: “The lymph nodes in your armpit area that we see on your mammogram are larger on the side where you had your recent COVID-19 vaccine. Enlarged lymph nodes are common after the COVID-19 vaccine and are your body’s normal reaction to the vaccine. However, if you feel a lump in your armpit that lasts for more than six weeks after your vaccination, you should let your health care provider know.”

During the pandemic, screening mammograms and breast cancer diagnoses have declined sharply in many health care institutions, Lehman said. She said this may result in a surge in cancers diagnosed at later stages when it is harder to treat and an increased demand for cancer screening procedures as delayed tests are rescheduled.

“We believe our model can avoid reducing or delaying vaccinations and avoid further reduced or delayed breast cancer diagnoses based on confusion amongst patients and/or their providers,” Lehman said.

The report was published online recently in the American Journal of Roentgenology.

More information

The U.S. Centers for Disease Control and Prevention has more information on COVID-19 vaccination.

SOURCE: Massachusetts General Hospital, news release, Feb. 24, 2021

Swollen lymph nodes: Doctors explain the COVID vaccine side effect that’s being mistaken for breast cancer

SAN FRANCISCO — As more people are getting vaccinated, doctors are seeing an influx of women making mammogram appointments after noticing swollen lymph nodes in the arm region where they got vaccinated.

Luz Pena, a reporter with ABC7’s sister station ABC7 News in San Francisco, spoke to experts who explain why you shouldn’t worry if this is happening to you.

Two days after getting the second Pfizer vaccine, Julie Mazenko felt a golf-ball size lump in her armpit.

“It was kind of painful and I touched and noticed that it was full of fluid,” said Mazenko, Discovery Bay resident.

RELATED | Reports of menstrual cycle changes after COVID vaccine highlight issues with clinical trials

Then she noticed a second one in her neck and a third in the other arm. One of the thoughts that crossed her mind was breast cancer.

“I do have a family history of breast cancer and I was a little concerned,” said Mazenko.

Dr. Laura Esserman is the director of University of California San Francisco’s Breast Care Center and says Julie is not alone. They’re getting an influx of calls from women who are confusing swollen lymph nodes after the vaccine for signs of cancer.

MORE | Women more likely to experience serious side effects from COVID-19 vaccine, CDC study reveals

“I’m sure hundreds of thousands of women across the country will be affected by this for sure,” said Dr. Esserman.

Most people get their vaccine in the shoulder area and it turns out we have 20-40 lymph nodes in that region. But why is the vaccine triggering them?

“The lymph nodes when they get swollen, if you have an infection, are just doing their job. In the case of a vaccine they are manufacturing the antibody for your body which is what you want,” said Dr. Esserman.

Luz Pena: “Have you noticed a difference between women who have swollen lymph nodes because of the vaccine and swollen lymph nodes because of cancer?”

Dr. Esserman: “On the mammogram they will just look bigger so you can’t really tell. On an exam, usually, sometimes that is obviously cancer. It is harder and more obvious.”

The Society of Breast Imaging reported that 11.6% of patients who received the Moderna COVID-19 vaccine had swollen lymph nodes after the first dose, and 16% after the second dose. Women who got the Pfizer vaccine also experienced these side effects.

MORE | SoCal doctor sets the record straight on COVID-19 vaccine and fertility

“It’s a phenomenon we’ve noticed and we are tracking it,” said Dr.Bonnie Joe.

Dr. Bonnie Joe is the Chief of Breast Imaging at UCSF. She is also noticing a pattern in the images.

“It’s usually the same side that the vaccine was on and generally they are higher up. So the breast cancer lymph nodes will spread from the breast from lower levels to higher levels,” said Dr. Joe.

According to these doctors, the swollen nodes should be gone in between 4-10 weeks. And here’s when you should worry.

“Definitely a breast lump is the concern. So any breast lump, any focal symptom or if you have bloody discharge,” said Dr. Joe and added that if you are concerned after getting a vaccine, “Better to come in and play it safe and let us take a look and then we can let you know what to do next.”

Dr. Joe says they have seen this with other vaccines.

“We use to see this with other vaccines too. It’s just that now so many people are getting COVID vaccinations it has kind of been spiking,” said Dr. Joe and added, “We just want people to know that this is a normal reaction and it’s not necessarily a sign of cancer.”

As for Julie, it’s been six days since her vaccine.

“Not too much of a decrease yet,” said Julie Mazenko.

Oncologists and breast imaging experts are advising women who have scheduled mammograms to get them before the vaccine or 4 to 8 weeks after they are fully vaccinated to get a clear picture of and avoid confusion.

Luz Pena: “Waiting those six to eight weeks if somebody does have breast cancer could that be detrimental to their health?”

Dr. Esserman: “Six to eight weeks is not going to make a difference one way or the other. Today what we understand about breast cancer is that it is not one disease it’s many different kinds and some are every slow growing and some are faster growing.”

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Swollen lymph nodes can be side effect of COVID-19 vaccine and confused for cancer, doctors say

Swollen lymph nodes can be side effect of COVID-19 vaccine

Dr. Constance Lehman, chief of Breast Imaging at Massachusetts General Hospital, discusses this side effect of COVID-19 vaccines and what it means for patients.

BOSTON – Swollen lymph nodes can be a normal and expected side effect after receiving the COVID-19 vaccine, doctors say — and many are working to spread the word in an effort to ease patients’ fears of cancer and avoid unnecessary testing.

As coronavirus vaccines roll out across the U.S., doctors are seeing more patients with enlarged lymph nodes under the armpit, along the collar bone and even up into the neck. This natural response can occur on the side where an individual received their injection and was a recognized side effect in both the Moderna and Pfizer-BioNtech clinical trials.

It can also happen in response to other vaccines beyond COVID-19.

“It’s actually sort of a good sign that your body is responding to this vaccine and creating those great antibodies to fight off COVID virus in the event that you ever come in contact with it,” said Dr. Constance Lehman, chief of Breast Imaging at Massachusetts General Hospital.

A provided image shows a left breast mammogram showing an enlarged axillary lymph node. (Photo credit: Massachusetts General Hospital)

Lymph nodes help the body fight off infections by functioning as a filter and trapping viruses, bacteria and other causes of illnesses.

Swollen lymph nodes usually occur as a result of infection from bacteria or viruses. In some cases, they can be an indication of cancer. The lymph nodes is one area that breast cancer most commonly spreads, according to the Cleveland Clinic.

In January, Lehman and her colleagues at the hospital’s breast imaging center in Boston began noticing more mammogram patients with enlarged lymph nodes while undergoing breast cancer screening. Prior to the pandemic, it wasn’t common practice to ask women about prior vaccines while getting a mammogram. 

Soon enough, doctors throughout the radiology department at Massachusetts General began discussing this same occurrence in other divisions, such as abdominal and chest imaging.

“We were all thinking this was probably going to show up in all kinds of patients, not just ones coming in for a mammogram,” she recalled, noting similar cases in a regular shoulder MRI and an ultrasound screening for another patient after having been successfully treated for thyroid cancer.

Lehman and her colleagues have since published journal articles on the topic and say it’s important for imaging centers to ask patients if they have received the COVID-19 vaccine, find out when it was injected and where it was administered in the body. If it was a two-dose vaccine, patients should share whether they most recently received the first or second shot.

In most cases, no additional testing is needed for swollen lymph nodes after recent vaccinations — unless the swelling persists or if the individual has other health issues. There is still more to learn as larger segments of the population are inoculated, but doctors think these symptoms should generally go away within six weeks. 

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They also share letters with patients in this situation, which reads: “The lymph nodes in your armpit area that we see on your mammogram are larger on the side where you had your recent COVID-19 vaccine. Enlarged lymph nodes are common after the COVID-19 vaccine and are your body’s normal reaction to the vaccine. However, if you feel a lump in your armpit that lasts for more than six weeks after your vaccination, you should let your health care provider know.”

Lehman says they are seeking to spread the word about this while still at the beginning stages of the country’s mass vaccination campaign. Doctors hope to reduce unnecessary biopsies or additional imaging of lymph nodes — and prevent added anxiety for patients who may fear the worst without knowing about this vaccine side effect. 

“The patients I feel, the most where my heart really goes out to them, are those in the midst of their cancer evaluation,” Lehman said. “They’ve been told that they have cancer and then they notice that their nodes are swollen, and then the concern is, ‘Could this be malignancy?’ That raises such anxiety and such fear, and we want to tackle that right away. ” 

Lehman said she also thinks of patients who have been successfully treated for their cancer and are now diligently going back for surveillance scans. 

“That’s really hard when those patients hear, ‘We see something in your lymph nodes.’ So we want to get the information out,” she added.

Still, there will be some cases that require a biopsy or additional imaging. Even though this response to the vaccine is normal, there will still be patients across the U.S. diagnosed with lymphoma, metastatic breast cancer or some other metastatic cancer.

“At one extreme, centers have been very concerned about lymph nodes and even went to the extremes of biopsying the lymph nodes to make sure that they weren’t cancer. That’s really an extreme that we’re all trying to stay away from. But the other extreme, people were saying it’s always about the vaccine and don’t worry about it at all. Just continue on as you always have been, and that’s an extreme where we don’t want to land either,” Lehman said.

Some in the field have suggested delaying routine imaging for at least six weeks after the last dose of vaccine. Lehman believes this should be a local community decision based on the resources available — but noted the thousands of women who already missed their routine mammograms in 2020 due to the pandemic.

“We’re trying to get them in now. I don’t want more barriers,” she said. “I think it’s so important that we just get our patients in.”

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Those who have not yet received a COVID-19 vaccine can request to have the injection on a particular arm or even in the thigh, as approved by the U.S. Centers for Disease Control and Prevention.

For those who have been diagnosed with cancer in the past or are currently going through treatment, Lehman said to consider asking for the injection to be farthest from the sight of where the cancer is located in the body.  

“That way, the area where we would be worried about lymph nodes the most on the side near her prior breast cancer is sort of spared from that reaction. People can use the same logic if they had cancer in another part of their body,” she said. 

Many expert medical groups recommend that most people with cancer or a history of cancer get the COVID-19 vaccine once it’s available to them, citing a risk for severe illness in those with a more fragile immune system. But as always, patients should discuss this with their doctor.

“If you haven’t been vaccinated yet, as soon as you can get in line and get vaccinated. Don’t worry about the sequella of having the vaccine and then having other imaging done. We want you to get vaccinated,” Lehman said.

This story was reported from Cincinnati. 

Dangerous symptoms of cancer of the lymph nodes

Redness of the skin, swelling and pain in the armpit more often speak of a disease such as axillary lymphadenopathy. It is not dangerous if detected and treated in time. There is a risk of developing an oncological process, so everyone should be able to recognize dangerous symptoms. Cancer can affect not only breast tissue, but also lymph nodes, which is much more dangerous.

Having identified a small lump in the armpit, most people think about cancer.It should be noted that the malignant process develops in the lymph nodes of the axillary region, and then affects the surrounding tissues. This form is common, but experts still have not identified what causes the pathology. Lymphoma includes more than 30 types of tumors (30% Hodgkin’s lymphoma and 70% non-Hodgkin’s). Damage to the lymphatic system can be a complication of other types of cancer. The following categories fall into the risk group:

  • men and women after 50 years;
  • adolescents and young people from 14 to 25 years old;
  • Europeans, namely, representatives of the light-skinned race;
  • people with autoimmune diseases;
  • women who gave birth after 35 years.

The environment is capable of causing cell mutation. It has been proven that those who have been in a radiation-contaminated area are more susceptible to cancer.

Dangerous symptoms

It is possible to identify a tumor on your own, but only tests will show whether it is benign or malignant. The first thing that pays attention to is the appearance of seals in the armpits. Pain, itching and peeling may occur (discomfort may affect the chest, arm, breast).As a rule, a person constantly has a temperature of at least 37.5-38 degrees. At night, he is worried about profuse sweating, as well as shortness of breath and shortness of breath. Against the background of impaired digestion, dramatic weight loss often occurs. Headaches, weakness, chills – all this indicates a malfunction in the body.

You should contact a surgeon who will conduct a thorough examination and prescribe an examination. It includes ultrasound, computed tomography or MRI. The doctor will make the final diagnosis only after a biopsy.

How many people live with cancer of the lymph nodes in the armpit

The sooner a tumor is detected and treatment is started, the better is the prognosis. In the early stages, lymphoma is successfully treated in most cases. Therapy at stages 2 and 3 has a good result – after 5 years after the operation, the survival rate is from 40 to 60%. A neglected disease is difficult to treat – the survival rate is 10%.

A lump in the armpit is not always indicative of a malignant tumor. In this way, many diseases are manifested.The first thing to do is visit a therapist or surgeon.

Material prepared by specialists of the site ginekolog.guru

Specialist advice on the prevention of lymphatic edema after mastectomy

Specialist’s advice on the prevention of lymphatic edema after mastectomy

Radical treatment of breast cancer – removal of the breast (or part of the breast) with the pectoral muscles, axillary, subclavian and subscapular lymph nodes. During the operation, the lymphatic pathways are crossed, the lymph nodes are removed, the nerves and nerve trunks are damaged, and postoperative scars are formed.

An early start of rehabilitation is therefore essential. In the first year after the operation, there is a high rehabilitation potential, it is important to use it.

“The first year after radical treatment for breast cancer is crucial for medical rehabilitation. Therefore, it should be considered important to maximize the use of this period to restore the lost functions of the body ”, – advises the physician for physiotherapy exercises of the rehabilitation department of the republican oncological dispensary Ekaterina Grigorieva .

According to the doctor, the main complication of the radical anticancer treatment of breast cancer is the violation of lymph drainage from the upper limb on the side of the operation. Clinically, this disorder manifests itself in the form of lymphatic edema of the upper limb.

In most cases, after radical mastectomy, lymphatic edema does not occur, but a latency period from 1-2 weeks to several years passes. And it occurs in the presence of provoking factors.

Other complications of radical antitumor treatment of breast cancer are in 23-57% of cases, limitation of mobility in the shoulder joint on the side of the operation.In 10-73% – brachial plexitis of varying severity. In 14-41% – gross cicatricial changes in the skin and soft tissues.

If the recommendations are violated, erysipelas (edema, redness) may occur. Against the background of impaired lymph circulation, when the transport function of the lymphatic system is sharply reduced, infectious complications such as erysipelas develop. Its appearance is facilitated by pathological proliferation of connective tissue, which creates a substrate for the existence of an infection in the event it enters the tissue.

Conservative methods of treatment of lymphatic edema:

  1. Physiotherapy exercises. The most affordable method that you can use without restrictions on your own.
  2. Treatment with an elevated position of the hand on the side of the operation
  3. Wearing compression hosiery
  4. From physiotherapy methods, pneumatic compression, low intense laser radiation, electrical neurostimulation , magnetic fields, light massage are used.

Rules for the prevention of lymphatic edema on the side of the operation

  1. Never ignore the appearance of even slight swelling of the hand, hand, or chest. Consult your doctor immediately.
  2. An injured arm should not be used for injection, blood collection.
  3. Measure blood pressure only on an intact arm or leg (thigh)
  4. It is necessary to observe hygiene, use moisturizing lotions after bathing.Wipe your hand gently but thoroughly. Make sure all creases and the skin between your toes are dry.
  5. Avoid repetitive vigorous movement
  6. Avoid extreme temperature fluctuations when bathing, and it is also not recommended to go to saunas and take hot baths. Always protect your hand from the sun.
  7. Try to avoid any kind of injury to the injured hand (bumps, cuts, sunburn, insect bites).
  8. Wear gloves when doing housework in the garden.Avoid cutting your cuticles when nailing.
  9. Talk to your doctor about an exercise program. Do not overload the injured hand.
  10. Women with large breasts should wear lightweight prostheses.
  11. Use an electric shaver to remove underarm hair.
  12. After mastectomy, special compression garments and a sleeve must be worn.
  13. Try to maintain your normal weight. A low-salt, fiber-fortified diet should be well balanced.Do not smoke or consume alcoholic beverages.
  14. After the operation, there may be problems with the spine, pain in the lower back, shoulder, muscles, so do not forget to do gymnastics daily for 15-30 minutes. Swimming also has beneficial effects in combating the onset of lymphedema and contributes to correct posture.

What are the different types of lymphoma?

Lymphoma is a type of cancer that affects the blood. There are two main types of lymphoma known as Hodgkin’s and non-Hodgkin’s.Non-Hodgkin’s lymphoma is then divided into the following groups, which include lymphoblastic, diffuse histiocytic, Burkitt’s lymphomas, and cutaneous T-cell lymphomas. Symptoms are often similar between all lymphomas, so a medical examination is necessary to get an accurate diagnosis of the exact type that is present in a particular situation. Some of the more common symptoms include fever, fatigue, swollen lymph nodes, and weight loss.

Hodgkin’s disease is less common than non-Hodgkin’s disease.Some of the most common symptoms include fever, chills, loss of appetite, and weight loss. Lymph nodes in the neck, armpits, and groin are often swollen but usually do not cause pain. Some patients, however, may experience lymph node pain after drinking alcohol. Other potential symptoms include night sweats, itching, chest pain, or difficulty breathing.

Non-Hodgkin’s lymphoma is by far the most common form of the disease. This type of cancer can then be classified into many different subtypes, but these subtypes are mostly grouped according to whether the cancer is growing rapidly or slowly.The symptoms of this type of cancer are the same as those of Hodgkin’s disease, so a medical examination is required to find out which form of cancer is present.

Some of the tests that may be prescribed for testing for lymphoma include blood and urine tests, physical examination, imaging tests, and biopsy. Blood and urine tests check for an increase in the number of special white blood cells known as lymphocytes. The physical examination includes the doctor feeling swelling of the lymph nodes and taking notes of recent weight loss. Imaging tests can include x-rays or CT scans designed to help healthcare professionals see any abnormalities or masses in the lymph nodes.A biopsy involves a minimally invasive surgical procedure in which a small amount of tissue is removed from a lymph node and sent to a laboratory for further testing.