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In this retrospective analysis, axillary adenopathy was seen in 3% of patients who had received at least one COVID-19 vaccine within the last 90 days. These imaging findings were found more frequently in symptomatic patients. The rates of adenopathy decreased as the number of days from the vaccine increased, with a cut-off date of 22.5 days. There was no association with age or type of vaccine.
The NCCN recommends scheduling breast imaging 4 to 6 weeks after the second COVID-19 vaccination dose. The rate of adenopathy seen was higher than the rate of incidental adenopathy found in unvaccinated patients, supporting a delay in imaging after COVID-19 vaccination.
Vaccine-induced adenopathy after COVID-19 vaccination in breast imaging has received significant media attention, with evolving literary correspondence on management. Patients’ self-report of axillary swelling following COVID-19 vaccination was reported as high as 16%. The National Comprehensive Cancer Network and Society of Breast Imaging recommended to consider scheduling screening breast imaging 4 to 6 weeks after the second COVID-19 vaccination dose when possible. However, the actual incidence, timing, and characteristics of mammographic axillary adenopathy following COVID-19 vaccination remain uncertain.