Ipsilateral Lymphadenopathy After COVID-19 Vaccination in Patients With Newly Diagnosed Breast Cancer

Abstract

This study aimed to evaluate the imaging and pathological findings in axillary lymph nodes in patients with breast cancer who received concurrent ipsilateral coronavirus disease 2019 (COVID-19) vaccination. Of the 19 women with breast cancer who received concurrent COVID-19 vaccination shot in the arm ipsilateral to breast cancer, axillary lymphadenopathy was observed in 84.2% (16 of 19) of patients on ultrasound (US) and 71.4% (10 of 14) of patients on magnetic resonance imaging (MRI), and 21.0% (4 of 19) of patients were diagnosed with metastasis. Abnormal US and MRI findings of cortical thickening, effacement of the fatty hilum, round shape, and asymmetry in the number or size relative to the contralateral side were noted in more than half of the non-metastatic and metastatic lymph nodes; however, statistical significance was not noted. Axillary lymphadenopathy is commonly observed in patients with breast cancer who receive concurrent ipsilateral COVID-19 vaccination without specific differential imaging features. Thus, understanding the limitations of axillary imaging and cautious interpretation is necessary to avoid overestimation or underestimation of the axillary disease burden.

Ipsilateral Lymphadenopathy, COVID-19 Vaccination and Breast Cancer

“…We would like to correspond and share ideas on the publication “Ipsilateral Lymphadenopathy After COVID-19 Vaccination in Patients With Newly Diagnosed Breast Cancer [ 1 ].”…”

“…Abnormal US and MRI findings of cortical thickening, effacement of the fatty hilum, round form, and asymmetry in the number or size relative to the contralateral side were observed in more than half of non-metastatic and metastatic lymph nodes, according to Ha et al [ 1 ]. Ha and colleagues [ 1 ] also noted that axillary lymphadenopathy was typically reported in breast cancer patients who got concurrent ipsilateral COVID-19 vaccination without distinct differential imaging findings. We agree that interpreting lymphadenopathy from an imaging investigation in a COVID-19 vaccination recipient is sometimes problematic.…”

“…Ha et al [ 1 ] stated that there should be no excessive unnecessary investigation, but did not offer any specific suggestions for how to handle the situation. In general, it is recommended that imaging should be avoided for the first 10 weeks after vaccination [ 2 ].…”

“…Additionally, Ha et al [ 1 ] attempted to link pathological and imaging findings in their investigation. If there is additional information on vaccination timing, a study of the relationship between lymphadenopathy features and the time between immunization and imaging could be assessed.…”

The Optimal Timing of Imaging Examinations in Patients With Newly Diagnosed Breast Cancer in the COVID-19 Pandemic Era

“…We would like to thank Dr. Pathum Sookaromdee and colleague for their interest in our work [ 1 ]. We read their remarks with interest, and would like to provide a response to some points that Dr. Pathum Sookaromdee mentioned [ 2 ].…”