Axillary adenopathy after COVID-19 vaccine in patients undergoing breast ultrasound

Giorgis, Sara De; Garlaschi, Alessandro; Brunetti, Nicole; Tosto, Simona; Rescinito, Giuseppe; Monetti, Francesco; Oddone, Claudio; Massa, Barbara; Pitto, Francesca; Calabrese, Massimo; Tagliafico, Alberto Stefano

doi:10.15557/jou.2021.0060

Abstract

After COVID-19 vaccination, a spectrum of axillary lymphadenopathy were observed in patients undergoing routine breast ultrasound. Malignancy remains the most serious differential in cases of unilateral axillary adenopathy. Knowledge of axillary ultrasound findings after COVID-19 vaccination is essential to prevent unnecessary biopsy or change in therapy in oncological patients. From March to May 2021, 10 female patients underwent breast ultrasound in our Department for the evaluation of axillary lumps. All the patients received their first or second dose of COVID-19 vaccine 20–30 days before the exam in the same extremity of the ultrasound evaluation where lymphadenopathy was found. Five patients had a personal history of previous breast cancer, and the radiologist decided to perform a core biopsy (the histology was negative for malignancy). The other five patients with no personal history of cancer underwent ultrasound and returned after a short-term follow-up. Regression of the enlarged lymph nodes was found.

References

Grasselli G, Pesenti A, Cecconi M: Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: early experience and forecast during an emergency response. JAMA 2020; 323: 1545–1546.
Search in Google Scholar Back to article
Fleming TR, Nason M, Krause PR, Longini IM, Henao-Restrepo AM: COVID-19 vaccine trials: the potential for „hybrid” analyses. Clin Trials 2021; 18: 391–397.
Search in Google Scholar Back to article
Gringeri M, Mosini G, Battini V, Cammarata G, Guarnieri G, Carnovale C et al.: Preliminary evidence on the safety profile of BNT162b2 (Comirnaty): new insights from data analysis in EudraVigilance and adverse reaction reports from an Italian health facility. Hum Vaccin Immunother 2021; 17: 2969–2971.
Search in Google Scholar Back to article
Sahin U, Muik A, Vogler I, Derhovanessian E, Kranz LM, Vormehr M et al.: BNT162b2 vaccine induces neutralizing antibodies and polyspecific T cells in humans. Nature 2021; 595: 572–577.
Search in Google Scholar Back to article
Skowronski DM, De Serres G: Safety and efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med 2021; 384: 1576–1577.
Search in Google Scholar Back to article
Cohen D, Hazut Krauthammer S, Cohen YC, Perry C, Avivi I, Herishanu Y et al.: Correlation between BNT162b2 mRNA Covid-19 vaccine-associated hypermetabolic lymphadenopathy and humoral immunity in patients with hematologic malignancy. Eur J Nucl Med Mol Imaging 2021; 48: 3540–3549.
Search in Google Scholar Back to article
Cohen D, Krauthammer SH, Wolf I, Even-Sapir E: Hypermetabolic lymphadenopathy following administration of BNT162b2 mRNA Covid-19 vaccine: incidence assessed by [18 F]FDG PET-CT and relevance to study interpretation. Eur J Nucl Med Mol Imaging 2021; 48: 1854–1863.
Search in Google Scholar Back to article
Eifer M, Tau N, Alhoubani Y, Kanana N, Domachevsky L, Shams J et al.: Covid-19 mRNA vaccination: age and immune status and its association with axillary lymph node PET/CT uptake. J Nucl Med 2021.
Search in Google Scholar Back to article
Hiller N, Goldberg SN, Cohen-Cymberknoh M, Vainstein V, Simanovsky N: Lymphadenopathy associated with the COVID-19 vaccine. Cureus 2021; 13: e13524.
Search in Google Scholar Back to article
Keshavarz P, Yazdanpanah F, Rafiee F, Mizandari M: Lymphadenopathy following COVID-19 vaccination: imaging findings review. Acad Radiol 2021; 28: 058–1071.
Search in Google Scholar Back to article
Tu W, Gierada DS, Joe BN: COVID-19 vaccination-related lymphadenopathy: what to be aware if. Radiol Imaging Cancer 2021; 3: e210038.
Search in Google Scholar Back to article
Vourtsis A, Berg WA: Breast density implications and supplemental screening. Eur Radiol 2019; 29: 1762–1777.
Search in Google Scholar Back to article
Tagliafico AS, Mariscotti G, Valdora F, Durando M, Nori J, La Forgia D et al.: A prospective comparative trial of adjunct screening with tomosynthesis or ultrasound in women with mammography-negative dense breasts (ASTOUND-2). Eur J Cancer 2018; 104: 39–46.
Search in Google Scholar Back to article
Tagliafico AS, Valdora F, Mariscotti G, Durando M, Nori J, La Forgia D et al.: An exploratory radiomics analysis on digital breast tomosynthesis in women with mammographically negative dense breasts. Breast 2018; 40: 92–96.
Search in Google Scholar Back to article
Dialani V, James DF, Slanetz PJ: A practical approach to imaging the axilla. Insights Imaging 2015; 6: 217–229.
Search in Google Scholar Back to article
Maxwell F, de Margerie Mellon C, Bricout M, Cauderlier E, Chapelier M, Albiter M et al.: Diagnostic strategy for the assessment of axillary lymph node status in breast cancer. Diagn Interv Imaging 2015; 96: 1089–1101.
Search in Google Scholar Back to article
Patel T, Given-Wilson RM, Thomas V: The clinical importance of axillary lymphadenopathy detected on screening mammography: revisited. Clinical radiology. 2005; 60: 64–71.
Search in Google Scholar Back to article
Özütemiz C, Krystosek LA, Church AL, Chauhan A, Ellermann JM, Domingo-Musibay E et al.: Lymphadenopathy in COVID-19 vaccine recipients: diagnostic dilemma in oncology patients. Radiology 2021; 300: E296–E300.
Search in Google Scholar Back to article
Becker AS, Perez-Johnston R, Chikarmane SA, Chen MM, El Homsi M, Feigin KN et al.: Multidisciplinary recommendations regarding post-vaccine adenopathy and radiologic imaging: Radiology Scientific Expert Panel. Radiology 2021; 300: E323–E327.
Search in Google Scholar Back to article

Axillary adenopathy after COVID-19 vaccine in patients undergoing breast ultrasound

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