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Sophia Zackrisson, MD, PhD. Photo.

Sophia Zackrisson

Manager

Sophia Zackrisson, MD, PhD. Photo.

European Society of Breast Imaging (EUSOBI) guidelines on the management of axillary lymphadenopathy after COVID-19 vaccination : 2023 revision

Author

  • Simone Schiaffino
  • Katja Pinker
  • Andrea Cozzi
  • Veronica Magni
  • Alexandra Athanasiou
  • Pascal A.T. Baltzer
  • Julia Camps Herrero
  • Paola Clauser
  • Eva M. Fallenberg
  • Gabor Forrai
  • Michael H. Fuchsjäger
  • Fiona J. Gilbert
  • Thomas Helbich
  • Fleur Kilburn-Toppin
  • Christiane K. Kuhl
  • Mihai Lesaru
  • Ritse M. Mann
  • Pietro Panizza
  • Federica Pediconi
  • Francesco Sardanelli
  • Tamar Sella
  • Isabelle Thomassin-Naggara
  • Sophia Zackrisson
  • Ruud M. Pijnappel
Show all

Summary, in English

Axillary lymphadenopathy is a common side effect of COVID-19 vaccination, leading to increased imaging-detected asymptomatic and symptomatic unilateral axillary lymphadenopathy. This has threatened to negatively impact the workflow of breast imaging services, leading to the release of ten recommendations by the European Society of Breast Imaging (EUSOBI) in August 2021. Considering the rapidly changing scenario and data scarcity, these initial recommendations kept a highly conservative approach. As of 2023, according to newly acquired evidence, EUSOBI proposes the following updates, in order to reduce unnecessary examinations and avoid delaying necessary examinations. First, recommendation n. 3 has been revised to state that breast examinations should not be delayed or rescheduled because of COVID-19 vaccination, as evidence from the first pandemic waves highlights how delayed or missed screening tests have a negative effect on breast cancer morbidity and mortality, and that there is a near-zero risk of subsequent malignant findings in asymptomatic patients who have unilateral lymphadenopathy and no suspicious breast findings. Second, recommendation n. 7 has been revised to simplify follow-up strategies: in patients without breast cancer history and no imaging findings suspicious for cancer, symptomatic and asymptomatic imaging-detected unilateral lymphadenopathy on the same side of recent COVID-19 vaccination (within 12 weeks) should be classified as a benign finding (BI-RADS 2) and no further work-up should be pursued. All other recommendations issued by EUSOBI in 2021 remain valid.

Department/s

  • LU Profile Area: Light and Materials
  • LTH Profile Area: Photon Science and Technology
  • LUCC: Lund University Cancer Centre
  • EpiHealth: Epidemiology for Health
  • Radiology Diagnostics, Malmö

Publishing year

2023

Language

English

Publication/Series

Insights into Imaging

Volume

14

Issue

1

Document type

Journal article

Publisher

Springer

Topic

  • Cancer and Oncology

Keywords

  • COVID-19 vaccines
  • Lymphadenopathy
  • Magnetic resonance imaging
  • Mammography
  • Ultrasonography (breast)

Status

Published

Research group

  • Radiology Diagnostics, Malmö

ISBN/ISSN/Other

  • ISSN: 1869-4101