Clinical Professor and Chief of Division of Breast Surgery, University of Hong Kong, China.
Clinical Professor and Chief of Division of Breast Surgery, University of Hong Kong, China.
Cancer Treat Res Commun. 2022;31:100546. doi: 10.1016/j.ctarc.2022.100546. Epub 2022 Mar 11.
; COVID-19 vaccines are commonly administered intramuscularly to the arm. Axillary lymphadenopathy has been reported as an adverse event after COVID-19 vaccination. In patients with breast cancers who received COVID-19 vaccination, presence of ipsilateral (or contralateral) lymphadenopathy poses diagnostic dilemma. This systematic review aims to evaluate the incidence and clinical characteristics of vaccine associated axillary lymphadenopathy.
; The systematic review was conducted with accordance to the PRISMA statement. The search terms used were "Vaccine" OR "Vaccination" AND "Lymphadenopathy" OR "Lymph node" AND "Covid-19″.
; 31 studies or reports were identified using the predefined keywords from the systematic review protocol. After excluding irrelevant papers (such as guidelines, reviews, opinions and commentaries), 10 studies or reports were included in the review.Pooled incidence of clinically detectable lymphadenopathy after COVID-19 vaccination was 91/22,532 (0.4%). Mean size of the vaccine associated axillary lymphadenopathy was 18.2 mm (Range 16 - 21 mm). Mean duration from vaccination to occurrence of axillary lymphadenopathy was 6.9 days (Range 2 - 18 days). In a study on 119 patients, enlarged axillary lymphadenopathy resolves in 4 to 5 weeks.
; Vaccine associated axillary lymphadenopathy is not uncommon. Management of it is based on multidisciplinary decision with patient demographics, vaccination history and radiological finding being taken into account. Additional imaging and biopsy may lead to unnecessary healthcare burden. Proper arrangement of vaccination and imaging regarding timing and laterality should be advocated to avoid confusion and patient anxiety.
COVID-19 疫苗通常肌肉注射于手臂。接种 COVID-19 疫苗后，曾有报道出现腋窝淋巴结病作为不良反应。在接受 COVID-19 疫苗接种的乳腺癌患者中，同侧（或对侧）淋巴结病的存在带来了诊断难题。本系统综述旨在评估疫苗相关腋窝淋巴结病的发生率和临床特征。
本系统综述按照 PRISMA 声明进行。使用的检索词为“疫苗”或“接种”和“淋巴结病”或“淋巴结”和“Covid-19”。
使用系统综述方案中预先定义的关键词，共确定了 31 项研究或报告。排除不相关的论文（如指南、综述、意见和评论）后，有 10 项研究或报告被纳入综述。COVID-19 疫苗接种后临床可检测到淋巴结病的总发生率为 91/22532（0.4%）。疫苗相关腋窝淋巴结病的平均大小为 18.2 毫米（范围 16-21 毫米）。从接种疫苗到出现腋窝淋巴结病的平均时间为 6.9 天（范围 2-18 天）。在一项针对 119 例患者的研究中，增大的腋窝淋巴结病在 4 至 5 周内消退。
疫苗相关腋窝淋巴结病并不少见。其管理基于多学科决策，考虑患者人口统计学、疫苗接种史和影像学发现。额外的影像学和活检可能会导致不必要的医疗保健负担。应提倡适当安排疫苗接种和影像学检查的时间和侧别，以避免混淆和患者焦虑。
