COVID-19 Vaccine-Related Axillary and Cervical Lymphadenopathy in Patients with Current or Prior Breast Cancer and Other Malignancies: Cross-Sectional Imaging Findings on MRI, CT, and PET-CT

Korean J Radiol. 2021 Dec;22(12):1938-1945. doi: 10.3348/kjr.2021.0350. Epub 2021 Oct 26.

Abstract

Breast radiologists are increasingly seeing patients with axillary adenopathy related to COVID-19 vaccination. Vaccination can cause levels I-III axillary as well as cervical lymphadenopathy. Appropriate management of vaccine-related adenopathy may vary depending on clinical context. In patients with current or past history of malignancy, vaccine-related adenopathy can be indistinguishable from nodal metastasis. This article presents imaging findings of oncology patients with adenopathy seen in the axilla or neck on cross-sectional imaging (breast MRI, CT, or PET-CT) after COVID-19 vaccination. Management approach and rationale is discussed, along with consideration on strategies to minimize false positives in vaccinated cancer patients. Time interval between vaccination and adenopathy seen on breast MRI, CT, or PET-CT is also reported.

Keywords: Breast MRI; Breast cancer; COVID-19; CT; Lymphadenopathy; PET-CT; Vaccine.

Publication types

  • Review

MeSH terms

  • Axilla
  • Breast Neoplasms* / diagnostic imaging
  • COVID-19 Vaccines
  • COVID-19*
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lymphadenopathy* / diagnostic imaging
  • Magnetic Resonance Imaging
  • Positron Emission Tomography Computed Tomography
  • SARS-CoV-2
  • Vaccines*

Substances

  • COVID-19 Vaccines
  • Vaccines
  • Fluorodeoxyglucose F18