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Axillary lymph nodes enlargement after Sars-CoV-2 vaccine in patients undergoing breast examination: a single-centre experience in 285 women

  • Breast Radiology
  • Published:
La radiologia medica

Abstract

Purpose

To assess the incidence of axillary lymphadenopathy over established time ranges after COVID-19 vaccination and lymph node pathologic features (i.e. size increase and qualitative characteristics) in subjects undergoing axillary evaluation during a breast imaging examination.

Methods and materials

The institutional review board approved this prospective study. Inclusion criteria: women undergoing mammography and breast ultrasound between July and October 2021; information about the COVID-19 vaccine and infection, if any. Exclusion criteria: known metastatic lymphadenopathy. Participants were divided into 5 subgroups according to time between vaccine and imaging: < 6 weeks; 7–8 weeks; 9–10 weeks; 11–12 weeks; > 12 weeks. Evaluation of axillary lymph nodes was performed with ultrasound. Descriptive statistical analysis was performed. p < 0.05 was considered significant.

Results

A total of 285 women were included. Most of the patients underwent Moderna vaccine (n = 175, 61.4%). 63/285 patients had a previous history of breast cancer (22.1%). 13/17 (76.5%) patients with previous COVID-19 infection had no previous history of cancer, whereas 4/17 had a previous history of cancer (p < .001). 41/285 (14.4%) women showed lymphadenopathy, and they were significantly younger (46.9 ± 11.6 years) than women with borderline (54.0 ± 11.9 years) or no lymphadenopathy (57.3 ± 11.9 years) (p < .001). Lymphadenopathy and borderline lymphadenopathy were more frequently observed in the Moderna-vaccinated women and in the subgroup of patients evaluated < 6 weeks after vaccination (p < 0.001). The most common pathologic feature was cortical thickening, followed by complete or partial effacement of fatty hilum.

Conclusion

A lymphadenopathy within 12 weeks after vaccination is a common finding particularly in younger women and after Moderna vaccine and no further assessment should be required.

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Funding

The Authors declare that no founds, grants or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Remistrasse 100, 8091, Zurich, Switzerland

    Magda Marcon

  2. Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale (EOC), Via Tesserete 46, 6900, Lugano, Switzerland

    Carola Catanese, Filippo Del Grande & Stefania Rizzo

  3. Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale, Via A. Gallino 12, 6500, Bellinzona, Switzerland

    Angela Lia Scarano

  4. Facoltà di Scienze Biomediche, Università della Svizzera Italiana USI, Via Buffi 13, 6900, Lugano, Switzerland

    Filippo Del Grande & Stefania Rizzo

  5. Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale, Via A. Turconi 23, 6850, Mendrisio, Switzerland

    Mario Manganiello

  6. Istituto di Imaging della Svizzera Italiana (IIMSI), Ente Ospedaliero Cantonale, Via All’ Ospedale 1, 6600, Locarno, Switzerland

    Monica Palermo

Authors
  1. Magda Marcon
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  2. Carola Catanese
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  7. Stefania Rizzo
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Contributions

All authors contributed to study conception and design. Material preparation, data collection and analysis were performed by CC, ALS, MM, SR and MP. All authors commented on previous version of the manuscript, All authors read and approved the final manuscript.

Corresponding author

Correspondence to Angela Lia Scarano.

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No conflict of interests to declare.

Ethics approval

The study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the appropriate Ethics Committee (Swissethics).

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Informed consent was obtained from all individual participants included in the study.

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Marcon, M., Catanese, C., Scarano, A.L. et al. Axillary lymph nodes enlargement after Sars-CoV-2 vaccine in patients undergoing breast examination: a single-centre experience in 285 women. Radiol med 128, 1217–1224 (2023). https://doi.org/10.1007/s11547-023-01696-5

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  • DOI: https://doi.org/10.1007/s11547-023-01696-5

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