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Kamboj M, Bohlke K, Baptiste DM, Dunleavy K, Fueger A, Jones L, Kelkar AH, Law LY, LeFebvre KB, Ljungman P, Miller ED, Meyer LA, Moore HN, Soares HP, Taplitz RA, Woldetsadik ES, Kohn EC. Vaccination of Adults With Cancer: ASCO Guideline. J Clin Oncol 2024; 42:1699-1721. [PMID: 38498792 PMCID: PMC11095883 DOI: 10.1200/jco.24.00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/11/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE To guide the vaccination of adults with solid tumors or hematologic malignancies. METHODS A systematic literature review identified systematic reviews, randomized controlled trials (RCTs), and nonrandomized studies on the efficacy and safety of vaccines used by adults with cancer or their household contacts. This review builds on a 2013 guideline by the Infectious Disease Society of America. PubMed and the Cochrane Library were searched from January 1, 2013, to February 16, 2023. ASCO convened an Expert Panel to review the evidence and formulate recommendations. RESULTS A total of 102 publications were included in the systematic review: 24 systematic reviews, 14 RCTs, and 64 nonrandomized studies. The largest body of evidence addressed COVID-19 vaccines. RECOMMENDATIONS The goal of vaccination is to limit the severity of infection and prevent infection where feasible. Optimizing vaccination status should be considered a key element in the care of patients with cancer. This approach includes the documentation of vaccination status at the time of the first patient visit; timely provision of recommended vaccines; and appropriate revaccination after hematopoietic stem-cell transplantation, chimeric antigen receptor T-cell therapy, or B-cell-depleting therapy. Active interaction and coordination among healthcare providers, including primary care practitioners, pharmacists, and nursing team members, are needed. Vaccination of household contacts will enhance protection for patients with cancer. Some vaccination and revaccination plans for patients with cancer may be affected by the underlying immune status and the anticancer therapy received. As a result, vaccine strategies may differ from the vaccine recommendations for the general healthy adult population vaccine.Additional information is available at www.asco.org/supportive-care-guidelines.
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Affiliation(s)
- Mini Kamboj
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY
| | - Kari Bohlke
- American Society of Clinical Oncology, Alexandria, VA
| | | | - Kieron Dunleavy
- MedStar Georgetown University Hospital, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
| | - Abbey Fueger
- The Leukemia and Lymphoma Society, Rye Brook, NY
| | - Lee Jones
- Fight Colorectal Cancer, Arlington, VA
| | - Amar H Kelkar
- Harvard Medical School, Dana Farber Cancer Institute, Boston, MA
| | | | | | - Per Ljungman
- Karolinska Comprehensive Cancer Center, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Eric D Miller
- The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | - Larissa A Meyer
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Heloisa P Soares
- Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT
| | | | | | - Elise C Kohn
- Cancer Therapy Evaluation Program, National Cancer Institute, Rockville, MD
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Parikh R, Feigin KN, Sevilimedu V, Huayanay J, Pinker K, Horvat JV. Comparison of Axillary Lymph Nodes on Breast MRI Before and After COVID-19 Booster Vaccination. Acad Radiol 2024; 31:755-760. [PMID: 37037711 PMCID: PMC10017388 DOI: 10.1016/j.acra.2023.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
RATIONALE AND OBJECTIVES Vaccine-related lymphadenopathy is a frequent finding following initial coronavirus disease 2019 (COVID-19) vaccination, but the frequency after COVID-19 booster vaccination is still unknown. In this study we compare axillary lymph node morphology on breast MRI before and after COVID-19 booster vaccination. MATERIALS AND METHODS This retrospective, single-center, IRB-approved study included patients who underwent breast MRI between October 2021 and December 2021 after the COVID-19 booster vaccination. The axillary lymph node with the greatest cortical thickness ipsilateral to the side of vaccination was measured on MRI after booster vaccination and before initial COVID-19 vaccination. Comparisons were made between patients with and without increase in cortical thickness of ≥ 0.2 cm. Continuous covariates were compared using Wilcoxon rank-sum test and categorical covariates were compared using Fisher's exact test. Multiple comparison adjustment was made using the Benjamini-Hochberg procedure. RESULTS All 128 patients were included. Twenty-four of 128 (19%) displayed an increase in lymph node cortical thickness of ≥ 0.2 cm. Patients who received the booster more recently were more likely to present cortical thickening, with a median of 9 days (IQR 5, 20) vs. 36 days (IQR 18, 59) (p < 0.001). Age (p = 0.5) and type of vaccine (p = 0.7) were not associated with thickening. No ipsilateral breast cancer or malignant lymphadenopathy were diagnosed on follow-up. CONCLUSION Axillary lymphadenopathy on breast MRI following COVID-19 booster vaccination is a frequent finding, especially in the first 3 weeks after vaccination. Additional evaluation or follow-up may be omitted in patients with low concern for malignancy.
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Affiliation(s)
- Rooshi Parikh
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 E 66th St., New York, NY 10065, USA; The City University of New York (CUNY) School of Medicine, New York, New York
| | - Kimberly N Feigin
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 E 66th St., New York, NY 10065, USA
| | - Varadan Sevilimedu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jorge Huayanay
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 E 66th St., New York, NY 10065, USA
| | - Katja Pinker
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 E 66th St., New York, NY 10065, USA
| | - Joao V Horvat
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 300 E 66th St., New York, NY 10065, USA.
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Destounis S. Axillary Lymphadenopathy Can Be Long Lasting Finding on MRI After COVID-19 Booster Vaccination. Acad Radiol 2024; 31:761-762. [PMID: 38129229 DOI: 10.1016/j.acra.2023.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023]
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Marcon M, Catanese C, Scarano AL, Del Grande F, Manganiello M, Palermo M, Rizzo S. Axillary lymph nodes enlargement after Sars-CoV-2 vaccine in patients undergoing breast examination: a single-centre experience in 285 women. LA RADIOLOGIA MEDICA 2023; 128:1217-1224. [PMID: 37626156 DOI: 10.1007/s11547-023-01696-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
PURPOSE To assess the incidence of axillary lymphadenopathy over established time ranges after COVID-19 vaccination and lymph node pathologic features (i.e. size increase and qualitative characteristics) in subjects undergoing axillary evaluation during a breast imaging examination. METHODS AND MATERIALS The institutional review board approved this prospective study. INCLUSION CRITERIA women undergoing mammography and breast ultrasound between July and October 2021; information about the COVID-19 vaccine and infection, if any. EXCLUSION CRITERIA known metastatic lymphadenopathy. Participants were divided into 5 subgroups according to time between vaccine and imaging: < 6 weeks; 7-8 weeks; 9-10 weeks; 11-12 weeks; > 12 weeks. Evaluation of axillary lymph nodes was performed with ultrasound. Descriptive statistical analysis was performed. p < 0.05 was considered significant. RESULTS A total of 285 women were included. Most of the patients underwent Moderna vaccine (n = 175, 61.4%). 63/285 patients had a previous history of breast cancer (22.1%). 13/17 (76.5%) patients with previous COVID-19 infection had no previous history of cancer, whereas 4/17 had a previous history of cancer (p < .001). 41/285 (14.4%) women showed lymphadenopathy, and they were significantly younger (46.9 ± 11.6 years) than women with borderline (54.0 ± 11.9 years) or no lymphadenopathy (57.3 ± 11.9 years) (p < .001). Lymphadenopathy and borderline lymphadenopathy were more frequently observed in the Moderna-vaccinated women and in the subgroup of patients evaluated < 6 weeks after vaccination (p < 0.001). The most common pathologic feature was cortical thickening, followed by complete or partial effacement of fatty hilum. CONCLUSION A lymphadenopathy within 12 weeks after vaccination is a common finding particularly in younger women and after Moderna vaccine and no further assessment should be required.
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Affiliation(s)
- Magda Marcon
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Remistrasse 100, 8091, Zurich, Switzerland
| | - Carola Catanese
- Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
| | - Angela Lia Scarano
- Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale, Via A. Gallino 12, 6500, Bellinzona, Switzerland.
| | - Filippo Del Grande
- Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
- Facoltà di Scienze Biomediche, Università della Svizzera Italiana USI, Via Buffi 13, 6900, Lugano, Switzerland
| | - Mario Manganiello
- Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale, Via A. Turconi 23, 6850, Mendrisio, Switzerland
| | - Monica Palermo
- Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale, Via All' Ospedale 1, 6600, Locarno, Switzerland
| | - Stefania Rizzo
- Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland
- Facoltà di Scienze Biomediche, Università della Svizzera Italiana USI, Via Buffi 13, 6900, Lugano, Switzerland
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Abstract
Coronavirus disease 2019 (COVID-19) is a viral disease that causes life-threatening health problems during acute illness, causing a pandemic and millions of deaths. Although computed tomography (CT) was used as a diagnostic tool for COVID-19 in the early period of the pan demic due to the inaccessibility or long duration of the polymerase chain reaction tests, cur rent studies have revealed that CT scan should not be used to diagnose COVID-19. However, radiologic findings are vital in assessing pneumonia severity and investigating complications in patients with COVID-19. Long-term symptoms, also known as long COVID, in people recovering from COVID-19 affect patients' quality of life and cause global health problems. Herein, we aimed to summarize the lessons learned in COVID-19 pneumonia, the challenges in diagnosing the disease and complications, and the prospects for future studies.
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Affiliation(s)
- Furkan Ufuk
- Department of Radiology, School of Medicine, University of Pamukkale, Denizli, Turkey
| | - Recep Savaş
- Department of Radiology, School of Medicine, University of Ege, Izmir, Turkey
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Nguyen DL, Chen X, Kwak L, Oluyemi ET, Mullen LA, Ambinder EB. Axillary adenopathy detected on breast MRI following COVID-19 vaccination: outcomes and follow-up recommendations. Clin Imaging 2022; 93:1-3. [PMCID: PMC9546499 DOI: 10.1016/j.clinimag.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/28/2022] [Accepted: 10/02/2022] [Indexed: 11/15/2022]
Abstract
This retrospective study presents 110 patients with suspected COVID-19 vaccine-related axillary adenopathy on breast MRI. Our study aimed to assess the outcomes of axillary adenopathy detected on breast MRI performed within one year after COVID-19 vaccination. The median time between the COVID-19 vaccine and breast MRI was shorter in patients with detected adenopathy compared to patients without detected adenopathy (6 weeks [2–17] versus 15 [7–24] weeks, p < 0.001). Unilateral axillary adenopathy detected on breast MRI had a low malignancy rate (3.3%), and no cases of malignant axillary adenopathy were diagnosed without a known breast cancer in the ipsilateral breast. Our findings suggest that unilateral axillary adenopathy identified on breast MRI ipsilateral to a recent COVID-19 vaccination can be considered benign in the absence of a suspicious breast finding or known breast cancer. Regardless of vaccine status and timing, unilateral axillary adenopathy detected on MRI evaluation with a known malignancy or suspicious breast finding should be considered suspicious. This will avoid unnecessary scheduling constraints, patient anxiety, and cost, without delaying diagnosis of metastatic breast cancer.
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Lamtai H, Boutayeb S, Mrabti H, El Ghissassi I, Errihani H. Cancer patients and COVID-19 vaccination, from safety to protocol adherence: A real-life setting report. Front Oncol 2022; 12:1014786. [PMID: 36263207 PMCID: PMC9573984 DOI: 10.3389/fonc.2022.1014786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/12/2022] [Indexed: 12/03/2022] Open
Abstract
Background The SARS-CoV-2 pandemic has slowed down cancer prevention and treatment strategies; consequently, cancer patients are prioritized to get the COVID-19 vaccines. Being constantly threatened by a new outbreak, the dive within the immunogenicity response is of great value; nonetheless, evaluating the side effects of these vaccines on fragile patients will assure their adherence to the vaccination protocol. Objectives This study sets out to investigate the adverse events reported about the vaccine according to its doses and types, and to compare the prevalence and severity of toxicities across two subgroups of cancer patients, those who received the injection during active therapy cycles, and those who have not started the therapy yet at vaccination time, moreover, this paper examines the will and commitment of this population to the vaccination schemes. Methods This is an observational, retrospective, cohort study, in which we conducted a semi-constructed interview with 415 random solid cancer patients treated at the National Institute of Oncology in Morocco. The assessment of adverse events was carried out with a standardized scale. Results Eleven months after the launch of the campaign, 75.2% of patients received at least one dose of the vaccine. Altogether, the analysis demonstrates a significant difference between the adverse effects reported post the second dose compared to the first one (p=0.004; odds ratio=2 [95% CI: 1.23 - 3.31]). Besides, the results indicate an increase in the rank of the severity of systemic events (p<0.001, r=0.28) after the second dose, but not for the local events (p=0.92, r=0.005). In the adjusted subgroup analysis, no effect was detected linking active therapy with the occurrence of toxicity (p=0.51, v=0.04) as well as with the level of severity reported after both; the first and second dose. Due to the fear of interactions with the therapy, we noticed a significant trend to delay the booster dose among the participants who completed the initial vaccine protocol. Conclusion A considerable body of evidence exists to persuade cancer patients to take the Coronavirus vaccines, and to also follow their vaccination schemes under the supervision of their treating physicians.
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Yoshikawa T, Miki S, Nakao T, Koshino S, Hayashi N, Abe O. Axillary Lymphadenopathy after Pfizer-BioNTech and Moderna COVID-19 Vaccination: MRI Evaluation. Radiology 2022; 306:270-278. [PMID: 36098641 PMCID: PMC9490792 DOI: 10.1148/radiol.220814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background COVID-19 vaccination-related axillary lymphadenopathy has become an important problem in cancer imaging. Data are needed to update or support imaging guidelines for conducting appropriate follow-up. Purpose To investigate the prevalence, predisposing factors, and MRI characteristics of COVID-19 vaccination-related axillary lymphadenopathy. Materials and Methods Prospectively collected prevaccination and postvaccination chest MRI scans were secondarily analyzed. Participants who underwent two doses of either the Pfizer-BioNTech or Moderna COVID-19 vaccine and chest MRI from June to October 2021 were included. Enlarged axillary lymph nodes were identified on postvaccination MRI scans compared with prevaccination scans. The lymph node diameter, signal intensity with T2-weighted imaging, and apparent diffusion coefficient (ADC) of the largest enlarged lymph nodes were measured. These values were compared between prevaccination and postvaccination MRI by using the Wilcoxon signed-rank test. Results Overall, 433 participants (mean age, 65 years ± 11 [SD]; 300 men and 133 women) were included. The prevalence of axillary lymphadenopathy in participants 1-14 days after vaccination was 65% (30 of 46). Participants with lymphadenopathy were younger than those without lymphadenopathy (P < .001). Female sex and the Moderna vaccine were predisposing factors (P = .005 and P = .003, respectively). Five or more enlarged lymph nodes were noted in 2% (eight of 433) of participants. Enlarged lymph nodes greater than or equal to 10 mm in the short axis were noted in 1% (four of 433) of participants. The median signal intensity relative to the muscle on T2-weighted images was 4.0; enlarged lymph nodes demonstrated a higher signal intensity (P = .002). The median ADC of enlarged lymph nodes after vaccination in 90 participants was 1.1 × 10-3 mm2/sec (range, 0.6-2.0 × 10-3 mm2/sec), thus ADC values remained normal. Conclusion Axillary lymphadenopathy after the second dose of the Pfizer-BioNTech or Moderna COVID-19 vaccines was frequent within 2 weeks after vaccination, was typically less than 10 mm in size, and had a normal apparent diffusion coefficient. © RSNA, 2022.
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Affiliation(s)
- Takeharu Yoshikawa
- From the Department of Computational Diagnostic Radiology and Preventive Medicine (T.Y., T.N., S.K., N.H.) and Department of Radiology (S.M., O.A.), University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Soichiro Miki
- From the Department of Computational Diagnostic Radiology and Preventive Medicine (T.Y., T.N., S.K., N.H.) and Department of Radiology (S.M., O.A.), University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Takahiro Nakao
- From the Department of Computational Diagnostic Radiology and Preventive Medicine (T.Y., T.N., S.K., N.H.) and Department of Radiology (S.M., O.A.), University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Saori Koshino
- From the Department of Computational Diagnostic Radiology and Preventive Medicine (T.Y., T.N., S.K., N.H.) and Department of Radiology (S.M., O.A.), University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Naoto Hayashi
- From the Department of Computational Diagnostic Radiology and Preventive Medicine (T.Y., T.N., S.K., N.H.) and Department of Radiology (S.M., O.A.), University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
| | - Osamu Abe
- From the Department of Computational Diagnostic Radiology and Preventive Medicine (T.Y., T.N., S.K., N.H.) and Department of Radiology (S.M., O.A.), University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan
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Aleman RT, Rauch J, Desai J, Chaiban JT. COVID-19 Vaccine-Associated Lymphadenopathy in Breast Imaging Recipients: A Review of Literature. Cureus 2022; 14:e26845. [PMID: 35974844 PMCID: PMC9375123 DOI: 10.7759/cureus.26845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 11/30/2022] Open
Abstract
The unpredictability of the coronavirus disease 2019 (COVID-19) pandemic has created an ongoing global healthcare crisis. Implementation of a mass vaccination program to accelerate disease control remains in progress. Although injection site soreness, fatigue, and fever are the most common adverse reactions reported after a COVID-19 vaccination, ipsilateral lymph node enlargement has increasingly been observed. In patients undergoing routine screening and surveillance for breast cancer, interpreting lymphadenopathy (LAP) is challenging in the setting of a recent COVID-19 vaccination. With a growing proportion of the population receiving the vaccine, a multifaceted approach is necessary to avoid unnecessary and costly workup. In this comprehensive review, we summarize the existing literature on COVID-19 vaccine-associated LAP in breast imaging patients.
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van Nijnatten T, Jochelson M, Lobbes M. Axillary lymph node characteristics in breast cancer patients versus post-COVID-19 vaccination: Overview of current evidence per imaging modality. Eur J Radiol 2022; 152:110334. [PMID: 35512513 PMCID: PMC9055782 DOI: 10.1016/j.ejrad.2022.110334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/13/2022] [Accepted: 04/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Axillary lymph node characteristics on axillary ultrasound (US), breast MRI and 18F-FDG PET/CT are relevant at breast cancer diagnosis. Axillary lymphadenopathy after COVID-19 vaccination has been frequently reported. This may cause a diagnostic dilemma, particularly in the ipsilateral axilla in women who have a either a recent diagnosis of breast cancer or a history of breast cancer. This review provides an overview of the current evidence regarding axillary lymph node characteristics at breast cancer diagnosis versus "post-COVID-19 vaccination". METHODS A non-systematic narrative review was performed. Studies describing axillary lymph node characteristics per imaging modality (axillary US, breast MRI and 18F-FDG PET/CT) in breast cancer patients versus post-COVID-19 vaccination were selected and used for the current study. RESULTS The morphologic characteristics and distribution of abnormal nodes on US may differ from the appearance of metastatic adenopathy since diffuse cortical thickening of the lymph nodes is the most observed characteristic after vaccination, whereas metastases show as most suspicious characteristics focal cortical thickening and effacement of the fatty hilum. Current evidence on MRI and 18F-FDG on morphologic characteristics of axillary lymphadenopathy is missing, although it was suggested that vaccine related lymphadenopathy is more likely to be present in level 2 and 3 nodes than metastatic nodes. Reported frequencies of lymphadenopathy post-COVID-19 vaccination range from 49% to 85% (US), 29% (breast MRI) and 14.5% to 53.9% (18F-FDG PET/CT). Several factors may impact the presence or extent of lymphadenopathy post-COVID-19 vaccination: injection site, type of vaccine (i.e., mRNA versus vector), time interval (days) between vaccination and imaging, previous history of COVID-19 pneumonia, and first versus second vaccine dose. CONCLUSION Although lymph node characteristics differ at breast cancer diagnosis versus post-COVID-19 vaccination, clinical information regarding injection site, vaccine type and vaccination date needs to be documented to improve the interpretation and guide treatment towards the next steps of action.
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Affiliation(s)
- T.J.A. van Nijnatten
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands,GROW – School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands,Corresponding author at: Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, the Netherlands
| | - M.S. Jochelson
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - M.B.I. Lobbes
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands,GROW – School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, the Netherlands,Department of Medical Imaging, Zuyderland Medical Center, Sittard-Geleen, the Netherlands
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