News | Breast Imaging | February 24, 2021

An open-access AJR article details both the clinical and the imaging features of adenopathy detected during screening and diagnostic breast mammography, ultrasound, and MRI after recent coronavirus disease vaccination (Pfizer-BioNTech and Moderna) to inform the development of follow-up recommendation

55-year-old woman who underwent screening mammogram and ultrasound 7 days after first COVID-19 vaccination dose. Screening mammogram and US demonstrated unilateral left axillary lymph node with cortical thickness of 5 mm on ultrasound (not shown). BI-RADS category 0 was assigned. Ultrasound from diagnostic work-up performed 7 days later showed no change in lymph node size. BI-RADS 3 was assigned. #COVIDvaccine #COVID19

55-year-old woman who underwent screening mammogram and ultrasound 7 days after first COVID-19 vaccination dose. Screening mammogram and US demonstrated unilateral left axillary lymph node with cortical thickness of 5 mm on ultrasound (not shown). BI-RADS category 0 was assigned. Ultrasound from diagnostic work-up performed 7 days later showed no change in lymph node size. BI-RADS 3 was assigned.


February 24, 2021 — An open-access article in ARRS’ American Journal of Roentgenology (AJR) describes the clinical and imaging features of axillary adenopathy detected during screening or diagnostic breast imaging after recent coronavirus disease (COVID-19) vaccination to inform the development of follow-up recommendations.[1]

Adenopathy is inflammation that involves glandular tissue or lymph nodes. This study shows the presence of swollen lymph nodes on mammograms of women who have received the COVID-19 vaccines and suggests patients should be asked if they recently received the vaccine. 

Shabnam Mortazavi, M.D., of the University of California at Los Angeles reviewed electronic medical records to identify women with post-COVID-19 vaccination adenopathy found from December 2020 to February 2021. For mammography, Mortazavi considered a node abnormal when its size, shape, or density was deemed disproportionate to other axillary nodes (ipsilateral or contralateral). On ultrasound, she deemed a node abnormal based on subjective assessment for cortical abnormalities, including focal or diffuse thickening greater than 3 mm, as well as nodal prominence compared to the contralateral axilla (when available). For MRI, Mortazavi considered a node abnormal when asymmetric in size and/or number to the contralateral axilla. 

Twenty-three women exhibited axillary adenopathy ipsilateral to the vaccinated arm on screening or diagnostic breast imaging, and according to Mortazavi, “13% were symptomatic (axillary lump with possible tenderness).” Meanwhile, the adenopathy was detected incidentally on screening breast imaging in 43% (mammography, 5; ultrasound, 2; both mammography and ultrasound, 1; high-risk screening MRI, 2) and on diagnostic imaging for other reasons in 43% (BI-RADS 3 follow-up for breast finding, 3; screening callback for other reason, 2; non-axillary breast pain or lump, 5). Noting that the median interval between the first vaccine dose and imaging showing the abnormal node  was 9.5 days, Mortazavi’s results counted a total of 57% of women with one abnormal node. BI-RADS 2 was assigned in one woman, BI-RADS 3 in 21 (ultrasound in 4–24 weeks), and BI-RADS 4 in one.

“The largest sample to our knowledge of COVID-19 vaccine associated axillary adenopathy on imaging,” Mortazavi also wrote, “this study highlights axillary adenopathy ipsilateral to the vaccinated arm with Pfizer-BioNTech or Moderna COVID-19 vaccine as a potential reactive process with which radiologists must be familiar.” Ultimately, vaccination date and laterality are critical to optimize assessment and management of imaging-detected axillary adenopathy in women with otherwise normal breast imaging.

For more information: www.arrs.org

 

VIDEO: COVID Vaccine May Cause Enlarged Lymph Nodes on Mammograms — Interview with Constance "Connie" Lehman, M.D., Mass General Hospital

PHOTO GALLERY: How COVID-19 Appears on Medical Imaging

CMS Now Requires COVID-19 Vaccinations for Healthcare Workers by January 4

Find more radiology related COVID content 

 

Reference: 

Related Content

News | Radiology Business

July 1, 2022 — Richard Fabian has been promoted to the role of Chief Executive Officer (CEO) of Fujifilm Sonosite, Inc ...

Time July 01, 2022
arrow
News | Radiology Business

June 29, 2022 — Siemens Healthineers and The Ohio State University Wexner Medical Center announced a new alliance, aimed ...

Time June 29, 2022
arrow
News | Ultrasound Imaging

June 28, 2022 — Mindray, a global leader and developer of healthcare technologies and solutions for ultrasound, patient ...

Time June 28, 2022
arrow
News | Mammography

June 23, 2022 — Black and Asian women are more likely than white women to experience significant delays in getting ...

Time June 23, 2022
arrow
News | Digital Radiography (DR)

June 22, 2022 — Canadian manufacturer KA Imaging unveiled a new brand identity for its patented dual-energy technology ...

Time June 22, 2022
arrow
News | MRI Breast

June 22, 2022 — According to ARRS’ American Journal of Roentgenology (AJR), contrast-enhanced mammography (CEM) may be a ...

Time June 22, 2022
arrow
News | Radiology Imaging

June 21, 2022 — After less than two years of data collection and processing, the Radiological Society of North America ...

Time June 21, 2022
arrow
News | Breast Imaging

June 10, 2022 — According to a new study, use of breast imaging services — including mammography screening — may remain ...

Time June 10, 2022
arrow
News | Breast Imaging

June 10, 2022 — Targeted text reminders and other interventions erased disparity in the rate of breast cancer screening ...

Time June 10, 2022
arrow
Feature

Imaging Technology News (ITN) maintains more than 40 comparison charts of product specifications from various vendors ...

Time June 09, 2022
arrow
Subscribe Now