Management of Unilateral Axillary Lymphadenopathy Detected on Breast MRI in the Era of COVID-19 Vaccination
| Autor: | Christine E Edmonds, Samantha P. Zuckerman, Emily F. Conant |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test Coronavirus disease 2019 (COVID-19) business.industry Breast imaging Incidence (epidemiology) Magnetic resonance imaging General Medicine 030218 nuclear medicine & medical imaging Vaccination 03 medical and health sciences Axilla 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Axillary Lymphadenopathy Medicine Breast MRI Radiology Nuclear Medicine and imaging Radiology business |
| Zdroj: | American Journal of Roentgenology. 217:831-834 |
| ISSN: | 1546-3141 0361-803X |
| DOI: | 10.2214/ajr.21.25604 |
| Popis: | Early clinical experience with COVID-19 vaccination suggests that approved COVID-19 vaccines cause a notably higher incidence of axillary lymphadenopathy on breast MRI compared with other vaccines. Guidelines are needed to appropriately manage unilateral axillary lymphadenopathy detected by MRI in the era of COVID-19 vaccination and to avoid biopsies of benign reactive nodes. This article examines the available data on vaccine-related lymphadenopathy and offers a basic strategy for assessing axillary lymphadenopathy on MRI and guiding management. At our institution, we are adding questions regarding the date(s) and laterality of administration of COVID-19 vaccination to the intake form given to patients before all breast imaging examinations. We consider MRI-detected isolated unilateral axillary lymphadenopathy ipsilateral to the vaccination arm to most likely be related to the COVID-19 vaccine if it develops within 4 weeks of administration of either dose. In these cases, we assess the lymphadenopathy as BI-RADS 3 and recommend that follow-up ultrasound be performed within 6-8 weeks after administration of the second dose. These guidelines may be refined as we acquire further data on the expected time course of axillary lymphadenopathy after COVID-19 vaccination. Until that time, this management pathway will help avoid unnecessary biopsies of benign vaccine-related reactive lymphadenopathy. |
| Databáze: | OpenAIRE |
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