Axillary Adenopathy after COVID-19 Vaccine: No Reason to Delay Screening Mammogram

Abstract

Online supplemental material is available for this article.

Graphical abstract

Figure 1:

Graphs compare (A) patients with and without lymphadenopathy (LAD) at initial breast imaging after COVID-19 vaccination. Lymphadenopathy is seen most commonly in the first 2 weeks after vaccination, but can also persist at least 10 weeks. (B) Graphs compare patients with LAD and follow-up imaging. Bars show the percent of examinations assigned Breast Imaging Reporting and Data System (BI-RADS) category 1 or 2 (negative or benign findings) versus BI-RADS 3 (probably benign finding; short-term follow-up is recommended) recommendations by time after the vaccination. Twenty-five percent of examinations performed at 0–12 weeks were given BI-RADS 3 recommendations, and none of these patients were subsequently diagnosed with a new malignancy.

Figure 2:

In a 46-year-old patient with a strong family history of breast cancer, (A) a screening US prior to COVID-19 vaccination demonstrated a morphologically normal left axillary lymph node. (B) Twenty-five days following the second dose of the COVID-19 vaccine, the patient presented with a palpable lump in the left axilla and US demonstrated enlarged lymph nodes with cortex measuring up to 6 mm in thickness (arrow). (C) Follow-up US 21 weeks following demonstrated stable axillary lymphadenopathy. (D) A US-guided core biopsy was then recommended and pathologic analysis demonstrated lymphoid cells negative for carcinoma. Arrows indicate the path of the needle.