Lymphadenopathy Associated with COVID-19 Vaccination Mimicking Breast Cancer Related Axillary LAP: Imaging Findings in Review of 880 Cases COVID-19 Vaccination LAP mimicking breast cancer

Pedram Keshavarz (1), Fereshteh Yazdanpanah (2), Seyed Faraz Nejati (3), Faranak Ebrahimian Sadabad (4), Fatemeh Bagheri (5), Malkhaz Mizandari (6)
(1) Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, USA, United States,
(2) Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tabriz, Iran, Iran, Islamic Republic of,
(3) Faraparto Medical Imaging & Interventional Radiology Research Center, Shiraz, Iran, Iran, Islamic Republic of,
(4) Faraparto Medical Imaging & Interventional Radiology Research Center, Shiraz, Iran, Iran, Islamic Republic of,
(5) Faraparto Medical Imaging & Interventional Radiology Research Center, Shiraz, Iran, Iran, Islamic Republic of,
(6) Department of Radiology of Tbilisi State Medical University (TSMU), Tbilisi, Georgia, USA, Georgia


Background: With an increasing rate of lymphadenopathies (LAP) reported following COVID-19 vaccination with various vaccines’ types, which can mimic breast cancer (BC), a comprehensive review, can disclose some practical information about BC workup that reduces the incidence and mortality of the disease along with unnecessary steps.

Methods: We conducted a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), Cochrane library, and Google Scholar. Keywords of literature search included “COVID-19”, “coronavirus disease”, “Vaccine”, and “Vaccination”, “LAP”, “Adverse event*”, “Lymph node”, “Cancer, breast”, and “Lymphadenopathy”.

Results: In total, 59 studies (n = 880 cases), including 412 (46.8%) females, 146 (16.6%) males, and 322 (36.6%) cases with unknown gender were reviewed. We reviewed the LAP presentation after vaccination of first or second dosage of Pfizer-BioNTech (n = 754, 85.7%), Moderna (n = 38, 4.3%), Oxford-AstraZeneca (n = 39, 4.4%), Sputnik V (n = 1, 0.1%), Johnson & Johnson/Janssen (n = 1, 0.1%), CureVac (n = 1, 0.1%), and in 46 (5.3%) cases, the type of vaccine was not reported. The most common LAP locations were axillary (n = 540) and followed by axillary and supraclavicular (n = 271). We found that imaging findings of LAP associated with vaccination were seen from the first day to two months after vaccination of the first or second dosage of different types of COVID-19 vaccines.

Conclusion:  This review study can draw a broad perspective by focusing on patients with cancer, especially BC, for clinicians to proceed with the right approach at the right time without additional invasive measures and not to hold the necessary action in high-risk patients at the same time.

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Pedram Keshavarz
Fereshteh Yazdanpanah
Seyed Faraz Nejati
Faranak Ebrahimian Sadabad
Fatemeh Bagheri
Malkhaz Mizandari (Primary Contact)
Keshavarz P, Yazdanpanah F, Nejati SF, Ebrahimian Sadabad F, Bagheri F, Mizandari M. Lymphadenopathy Associated with COVID-19 Vaccination Mimicking Breast Cancer Related Axillary LAP: Imaging Findings in Review of 880 Cases: COVID-19 Vaccination LAP mimicking breast cancer. Arch Breast Cancer [Internet]. 2022 Apr. 23 [cited 2023 Oct. 4];9(3). Available from:

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