PDF(Pubmed)
Abstract：
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.
摘要：
腋窝淋巴结病是COVID-19疫苗接种的常见副作用，导致影像学检测到的无症状和有症状的单侧腋窝淋巴结病增加。这可能会对乳房成像服务的工作流程产生负面影响，导致欧洲乳腺成像学会（EUSOBI）于2021年8月发布十项建议。考虑到快速变化的场景和数据稀缺，这些最初的建议保持了高度保守的态度。截至2023年，根据新获得的证据，EUSOBI提出了以下更新，为了减少不必要的考试，避免延误必要的考试。首先,建议n。3已经修订，规定乳房检查不应因为COVID-19疫苗接种而推迟或重新安排，因为来自第一波大流行浪潮的证据强调了延迟或错过的筛查测试如何对乳腺癌发病率和死亡率产生负面影响，并且在无症状的单侧淋巴结肿大且无可疑乳腺发现的患者中，随后出现恶性发现的风险接近于零。第二,建议n.7已修订，以简化随访策略：在没有乳腺癌病史且没有可疑癌症的影像学发现的患者中，近期COVID-19疫苗接种(12周内)在同一侧的有症状和无症状影像学检查发现的单侧淋巴结肿大应归类为良性发现(BI-RADS2),不应进行进一步检查.EUSOBI在2021年发布的所有其他建议仍然有效。
