Lymphadenopathy Associated with COVID-۱۹ Vaccination Mimicking Breast Cancer Related Axillary LAP: Imaging Findings Review of ۸۸۰ Cases

Background: With an increasing rate of lymphadenopathies (LAP) reported following COVID-۱۹ vaccination with various vaccines, which can mimic breast cancer (BC), a comprehensive review, can disclose some practical information about BC workup that reduces the incidence and mortality of the disease along with unnecessary steps. Methods: We conducted a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), Cochrane library, and Google Scholar. Keywords of literature search included “COVID-۱۹”, “coronavirus disease”, “Vaccine”, and “Vaccination”, “LAP”, “Adverse event*”, “Lymph node”, “Cancer, breast”, and “Lymphadenopathy”. Results: In total, ۵۹ studies (n=۸۸۰ cases), including ۴۱۲ (۴۶.۸%) females, ۱۴۶ (۱۶.۶%) males, and ۳۲۲ (۳۶.۶%) cases with unknown gender were reviewed. We reviewed the LAP presentation after vaccination of the first or second dosage of Pfizer-BioNTech (n=۷۵۴, ۸۵.۷%), Moderna (n=۳۸, ۴.۳%), Oxford-AstraZeneca (n=۳۹, ۴.۴%), Sputnik V (n=۱, ۰.۱%), Johnson & Johnson/Janssen (n=۱, ۰.۱%), and CureVac (n=۱, ۰.۱%). In ۴۶ (۵.۳%) cases, the type of vaccine was not reported. The most common LAP locations were axillary (n=۵۴۰), followed by axillary and supraclavicular (n=۲۷۱). We found that imaging findings of LAP associated with vaccination were seen from the first day to two months after vaccination of the first or second dosage of different types of COVID-۱۹ vaccines. Conclusion: This review study can draw a broad perspective by focusing on patients with cancer, especially BC, for clinicians to proceed with the right approach at the right time without additional invasive measures and not to delay the necessary measures in high-risk patients at the same time.

Keywords:

COVID-۱۹ , Lymphadenopathy , Vaccination , Cancer , Breast Cancer