COVID-19 Vaccine-Associated Subclinical Axillary Lymphadenopathy on Screening Mammogram

Raj, Sean D.; Ogola, Gerald; Han, Jordan

doi:10.1016/j.acra.2021.11.010

Cited by 12 publications

(8 citation statements)

References 9 publications

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“…There are some reports about two dose COVID-19 vaccine-induced axillary lymph node swelling (12)(13)(14). Raj et al reported this side-effect on screening mammography (15), and Romeo et al reported it in a prospective study (16). However, there have been few reports about the sideeffects of a third COVID-19 vaccination.…”

Section: Discussionmentioning

confidence: 99%

Axillary Lymph Node Swelling After COVID-19 Booster Vaccination: Japanese Case Report and Literature Review

Yoshimoto

Yanagi

Takayama

et al. 2022

In Vivo

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Background/Aim: COVID-19 has been a global pandemic for more than 2 years, and vaccination against COVID-19 using an mRNA vaccine is widespread. The COVID-19 vaccination can cause specific side-effects, such as axillary lymph node swelling; therefore, breast oncologists should pay attention to such occurrences. Initially, only two COVID-19 vaccinations were planned; however, in some countries third or fourth vaccines have been administered. Here, we present a female case who developed axillary lymph node swelling after her third vaccination. We have also reviewed the literature regarding this side-effect after a third or fourth COVID-19 vaccination. Case Report: A 64-year-old woman who came to our clinic regarding a mammography abnormality in her left breast. She had no palpable mass, but a left breast mass was shown by mammography, and ultrasonography and magnetic resonance imaging indicated a hamartoma. At 2 months after her second COVID-19 vaccination when she underwent these tests, she had no axillary lymph node swelling. We planned a follow-up after 6 months. At her next visit, by chance, she underwent ultrasonography 14 days after she received a third COVID-19 vaccination, and a swollen axillary lymph node was observed. Conclusion: Axillary lymph node swelling can occur after a third COVID-19 vaccination. Therefore, breast oncologists will have to consider this side-effect of COVID-19 vaccination when diagnosing breast tumors. Pneumonia caused by the novel coronavirus, called Coronavirus Disease 2019 (COVID-19), was first reported in Wuhan, China in December 2019 (1). Two years later and the pandemic has become global. During this pandemic, COVID-19 vaccines, such as the BNT162b2 vaccine (Pfizer) (2) and mRNA-1273 vaccine (Moderna) (3), have been developed rapidly, and in many countries, including Japan, vaccination with these vaccines has been performed. BNT162b2 and mRNA-1273 are mRNA vaccines and this is the first time this type of vaccine has been used in a clinical setting.When these vaccinations were started, clinical trials of BNT162b2 and mRNA-1273 (2, 3) were designed to administer two doses. However, this pandemic has continued for 2 years, and therefore booster vaccinations have been required to prevent COVID-19 infection because antibody levels to the virus decrease within several months. In Japan, the third vaccination started in December 2021 (4). Currently, a third vaccination is indicated for those who received a second vaccination more than 6 months previously, and further vaccination might be needed. Indeed, Japan is planning to administer a fourth COVID-19 vaccination (5).These vaccines have characteristic side-effects including fever, general fatigue, injection-site pain, and swelling (2). In addition, local lymph node swelling can also occur after these vaccinations (3). In cases of axillary lymph node swelling, breast oncologists should consider whether these swellings are metastases of breast cancer or a side-effect of the vaccine. Here, we present a case with axillary lymph node swel...

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Section: Discussionmentioning

confidence: 99%

Axillary Lymph Node Swelling After COVID-19 Booster Vaccination: Japanese Case Report and Literature Review

Yoshimoto

Yanagi

Takayama

et al. 2022

In Vivo

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“…The axillary pathology of these patients was clean. In some publications, it has been declared that mammography scans may be postponed due to vaccine-induced axillary lymphadenopathy [ 9 , 31 , 32 ]. However, considering such effect of vaccination on breast cancer patients, we believe that mammography shouldn’t be delayed.…”

Section: Discussionmentioning

confidence: 99%

Axillary Lymph Nodes in Breast Cancer Patients After COVID-19 Vaccine

et al. 2023

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One of the side effects of vaccines used to end the COVID-19 epidemic is non-specifically enlarged axillary lymph nodes. Such lymphadenopathy detected during clinical examination of breast cancer patients may require additional imaging or interventional procedures that should not normally be performed. This study has been designed to estimate the incidence of palpable enlarged axillary lymph node in breast cancer patients who had received COVID-19 vaccination in the past 3 months in the same arm as compared to those without vaccination. Breast cancer patients admitted to M.U. Medical Faculty Breast polyclinic between January 2021 and March 2022 were screened, and clinical staging was performed after thorough clinical examination. Among these patients with suspected enlarged axillary lymph node and those undergoing sentinel lymph node biopsy (SLNB), they were divided into two groups as vaccinated and unvaccinated. Age, menopausal status, tumor size, tumor location, surgery, pathology results, hormonal receptor status, and SLNB results were statistically compared with groups. There was no significant difference between groups in terms of age, menopause, tumor size, tumor location, surgery, pathological results, and hormone receptor status. The SLNB being reported as reactive only was 89.1% in the vaccinated group and 73.2% in the non-vaccinated group which was statistically significant different. Reactive lymph nodes were commonly found with an excess of 16% in patients who had received COVID-19 vaccination in the past 3 months. This required caution and additional examination of the axillary lymph nodes in this period.

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“…In this setting, different approaches are proposed. For example, while Wolfson et al [6] suggest not to delay the screening mammograms and to interpret the investigation considering the patients risk factors and the presence of other mammographic findings in the ipsilateral breast, Raj et al [7] advise to consider to anticipate or postpone the vaccination by 8 weeks in order to avoid unnecessary and bothersome follow-up examinations.…”

Section: Invited Commentarymentioning

confidence: 99%