Lymphadenopathy on breast ultrasound lasts longer than reported

2022 05 20 21 28 0348 2022 05 18 Ajr Lymphadenopathy Ultrasound 20220520210923

Axillary lymphadenopathy linked to COVID-19 vaccination lasts longer than reported in initial vaccine clinical trials, suggests a study published May 18 in the American Journal of Roentgenology (AJR).

A team led by Dr. Michele Drotman from Weill Cornell Medicine in New York City found in their single-center study of 111 patients that lymphadenopathy detected by breast ultrasound resolved on its own after an average of 97 days since detection and 127 days since the first dose. The team also found longer resolution times with Moderna vaccination, receipt of a second vaccine dose after presentation, and thicker cortical thickness at presentation.

(Left) An increased cortical thickness of 4 mm (arrow) is seen in a transverse image of left axilla on initial breast ultrasound in a 33-year-old woman, 19 days after the first dose of the Pfizer COVID-19 vaccination to left upper extremity. (Right) About 100 days after the woman received her first COVID-19 vaccine dose, her ultrasound showed a cortical thickness of 2 mm (arrow), consistent with resolution of left axillary lymphadenopathy (arrow). The woman underwent a second dose two days after the initial ultrasound.Image courtesy of the AJR.(Left) An increased cortical thickness of 4 mm (arrow) is seen in a transverse image of left axilla on initial breast ultrasound in a 33-year-old woman, 19 days after the first dose of the Pfizer COVID-19 vaccination to left upper extremity. (Right) About 100 days after the woman received her first COVID-19 vaccine dose, her ultrasound showed a cortical thickness of 2 mm (arrow), consistent with resolution of left axillary lymphadenopathy (arrow). The woman underwent a second dose two days after the initial ultrasound.Image courtesy of the AJR.

The researchers wrote that these results support a follow-up interval of at least 12 weeks for suspected vaccine-related lymphadenopathy, as well as avoiding screening mammography delays after vaccination.

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