The Challenge of Staging Breast Cancer With PET/CT in the Era of COVID Vaccination

Clin Nucl Med. 2021 Dec 1;46(12):1006-1010. doi: 10.1097/RLU.0000000000003683.

Abstract

We report a case series of biopsy-proven reactive axillary lymph nodes, which were avid on FDG PET/CT in breast cancer patients post COVID-19 vaccination. With 4 cases presenting in a consecutive 10-day period, it became apparent that metabolically active axillary lymphadenopathy is an adverse effect of COVID-19 vaccines, currently being deployed worldwide. This may lead to patients undergoing unnecessary biopsy. We have started taking a COVID-19 vaccine status history before PET/CT. If enlarged/metabolically active axillary nodes are identified in the ipsilateral vaccinated arm, then axillary ultrasound at 4 weeks is suggested.

MeSH terms

  • Breast Neoplasms* / diagnostic imaging
  • Breast Neoplasms* / pathology
  • COVID-19 Vaccines
  • COVID-19*
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Neoplasm Staging
  • Positron Emission Tomography Computed Tomography
  • SARS-CoV-2
  • Vaccination

Substances

  • COVID-19 Vaccines
  • Fluorodeoxyglucose F18