The COVID-19 Vaccines Can Lead to False Positive Mammograms and Breast MRI. How Can we Decrease the Impact Caused by Post-Vaccination Lymphadenopathy in Breast Cancer and Oncology Patients?

Abstract

There has been an increase in reporting clinical or radiological axillary lymphadenopathy after the coronavirus disease (COVID-19) vaccination. Cancer care is complex and multidisciplinary, which requires care events to be orchestrated promptly; radiology often serves a key role in diagnosis, post-diagnosis and is sometimes the patient’s first step in cancer care initiation, especially in breast cancer. Radiologists are also a key role in other Multidisciplinary Teams (MDT) dealing with different departments. Therefore, identifying unnecessary management within the health system can generally enhance the patient’s experience, reduce the pressure from providing extra health services, and reduce health costs. Based on personal observation and previous literature, the author concludes that patients having breast cancer or recent breast cancer diagnosis in the pre- or peri-treatment setting could benefit from receiving a vaccination, if possible, in the anterolateral thigh or contralateral arm regardless if this vaccine is for influenza, HPV, etc. Whether this is applicable for the COVID-19 vaccine remains unanswered. This approach will potentially reduce the patient anxiety from having a recurrence or failure of treatment and decrease the strain of the health care system both functionally and economically. In addition, this approach can potentially reduce or eliminate cancellations, delays, and rescheduling of relevant imaging modalities. Also, the author suggests adding a history of vaccinations to all the imaging request forms; countries with digital health services can reap the benefit of generating extensive epidemiological data of post-vaccination lymphadenopathy. Thus, creating new base-evidence guidelines for managing reactive post-vaccination lymphadenopathy, and potentially avoiding duplicating unnecessary imaging and patient over-treatment.