Unilateral Axillary Lymphadenopathy in Cancer Patients Post-COVID-19 Vaccination: Review and Case Series

Sumaya Hasan Zoughbor, Zakeya Alrasbi, Ali Yousif, Mouza Al Ameri, Mawada Mohamed Hussein, Mohammad Saeed Hourani, Shima Mohamed Khamis, Hidayath Ansari, Iram Syed, Khalid Balaraj, Fathi Azribi, Abdul Rahman Bin Sumaida, Emad Dawoud, Jawaher Ansari

Research output: Contribution to journalArticlepeer-review

Abstract

Novel coronavirus-19 (COVID-19) variants continue to spread worldwide with the development of highly transmissible strains. Several guidelines addressing management of cancer patients during the COVID-19 pandemic have been published, primarily based upon expert opinion. The COVID-19 pandemic has affected all aspects of breast cancer care including screening, diagnosis, treatment, and long-term follow-up. Recent reports indicate that mRNA COVID-19 vaccines can provoke lymphadenopathy in both cancer patients and healthy individuals. Unilateral axillary lymphadenopathy (UAL) post-COVID-19 vaccination is a challenging presentation for cancer patients because of the potential for misinterpretation as malignancy. The World Health Organization's target to vaccinate 70% of the world's population by mid-2023 is likely to increase the incidence of post-COVID-19 vaccination UAL. In this article, we review the published evidence regarding UAL post-COVID-19 vaccination and present diverse cases of breast cancer patients where false-positive UAL post-COVID-19 vaccination proved to be a therapeutic challenge. The United Arab Emirates (UAE) vaccination program is well ahead of other countries in the world, having accomplished the target of 100% vaccination of the population with at least one dose. Therefore, an increasing number of recently vaccinated patients are likely to present with UAL, detected by surveillance imaging, post-vaccination. We have therefore made recommendations regarding the management of cancer patients with UAL post-COVID-19 vaccination in order to avoid misdiagnosis and unnecessary imaging or invasive biopsy procedures.

Original languageEnglish
Pages (from-to)194-209
Number of pages16
JournalCase Reports in Oncology
Volume16
Issue number1
DOIs
Publication statusPublished - Apr 6 2023

Keywords

  • Breast cancer
  • COVID-19
  • Coronavirus
  • Lymphadenopathy
  • Pandemic
  • Positron emission tomography-computed tomography
  • Screening
  • Unilateral axillary lymphadenopathy
  • Vaccine

ASJC Scopus subject areas

  • Oncology

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