Vaccine-induced adenopathy after COVID-19 vaccination in breast imaging has received significant media attention, with evolving literary correspondence on management. Patients' self-report of axillary swelling following COVID-19 vaccination was reported as high as 16%. 1 The National Comprehensive Cancer Network and Society of Breast Imaging recommended to consider scheduling screening breast imaging 4 to 6 weeks after the second COVID-19 vaccination dose when possible. 2 However, the actual incidence, timing, and characteristics of mammographic axillary adenopathy following COVID-19 vaccination remain uncertain.Methods | Retrospective analysis was carried out assessing patients who received at least 1 injection of COVID-19 vaccine fewer than 90 days prior to either screening or diagnostic mam-mography at the Jacoby Center for Breast Health, Mayo Clinic, Florida, between January 15 and March 22, 2021. Information regarding COVID-19 vaccination and symptomatic adenopathy was inquired by technicians performing mammography and documented in the electronic medical record. Axillary adenopathy was assessed by interpreting radiologists and all adenopathy cases were re-reviewed. Wilcoxon rank-sum test and Fisher exact test were used to compare continuous and categorical variables, respectively. Multivariable logistic regression model was used to evaluate the association between days from vaccine and adenopathy. Receiver operating curve (ROC) analysis was used to assess potential cutoff days after vaccine and adenopathy. The analysis was done using R version 3.6.2. This study and waiver of informed consent were approved by Mayo Clinic Institutional Review Board.

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The aim of the current study was to describe the risk of hepatotoxicity for patients with gastroenteropancreatic neuroendocrine tumors undergoing peptide receptor radionuclide therapy (PRRT) with a very high liver tumor burden, defined as tumor involving more than 75% of the liver. Methods: We conducted a retrospective analysis of 371 patients who received at least 1 cycle of 177 Lu-DOTATATE at Mayo Clinic for advanced gastroenteropancreatic neuroendocrine tumors. We identified 15 total patients with more than 75% liver involvement on 68 Ga-DOTATATE PET/CT and with either a contrast-enhanced abdominal MRI or dual-phase abdominal CT examination. Results: Of the 15 patients with more than 75% liver involvement, 1 experienced hepatotoxicity (i.e., worsening liver enzymes or bilirubin) as defined by the Common Terminology Criteria for Adverse Events, version 5.0. No patients had grade 3-5 hepatotoxicity (i.e., clinical signs of liver failure). Conclusion: When considering the risk of liver injury from PRRT due to burden of disease, our data suggest that PRRT may be a safe option in patients with more than 75% liver involvement. Future efforts should be made to determine the safety profile of PRRT in patients with varying degrees of liver involvement.