Axillary adenopathy detected on breast MRI following COVID-19 vaccination: outcomes and follow-up recommendations.

This retrospective study presents 110 patients with suspected COVID-19 vaccine-related axillary adenopathy on breast MRI. Our study aimed to assess the outcomes of axillary adenopathy detected on breast MRI performed within one year after COVID-19 vaccination. The median time between the COVID-19 vaccine and breast MRI was shorter in patients with detected adenopathy compared to patients without detected adenopathy (6 weeks [2-17] versus 15 [7-24] weeks, p < 0.001). Unilateral axillary adenopathy detected on breast MRI had a low malignancy rate (3.3%), and no cases of malignant axillary adenopathy were diagnosed without a known breast cancer in the ipsilateral breast. Our findings suggest that unilateral axillary adenopathy identified on breast MRI ipsilateral to a recent COVID-19 vaccination can be considered benign in the absence of a suspicious breast finding or known breast cancer. Regardless of vaccine status and timing, unilateral axillary adenopathy detected on MRI evaluation with a known malignancy or suspicious breast finding should be considered suspicious. This will avoid unnecessary scheduling constraints, patient anxiety, and cost, without delaying diagnosis of metastatic breast cancer.

Addressing Disparities Related to Access of Multimodality Breast Imaging Services Before and During the COVID-19 Pandemic.

Despite technological advancements focused on reducing breast cancer mortality through early detection, there have been reported disparities in the access to these imaging services with underserved patient populations (including racial minority groups and patients of low socioeconomic status) showing underutilization compared to other patient groups. These underserved populations tend to have more advanced breast cancer presentations, in part due to delays in diagnosis resulting in later stage of disease presentation. To make matters worse, the COVID-19 pandemic declared in March 2020 has resulted in significant healthcare disruptions leading to extensive delays in breast imaging services which are expected to negatively impact breast cancer mortality long-term. Given the worsening disparity in breast cancer mortality among racial/ethnic minorities and financially disadvantaged groups, it is vital to address these disparity gaps with the goal of reducing the barriers to timely breast cancer diagnosis and addressing breast cancer mortality differences among breast cancer patients. Therefore, this review aims to provide a discussion highlighting the disparities related to breast imaging access, the effects of the COVID-19 pandemic on these disparities, current targeted interventions implemented in breast imaging practices to reduce these disparities, and future directions on the journey to reducing disparity gaps for breast imaging patients. Tackling the root cause factors of the persistent breast cancer-related disparities is critical to meeting the needs of patients who are disadvantaged and can lead to continued improvement in the quality of individualized care for patients who have higher breast cancer morbidity and mortality risks.

COVID-19 Vaccine-Related Axillary Adenopathy on Breast Imaging: Follow-Up Recommendations and Histopathologic Findings.

This study describes 94 patients who presented with suspected COVID-19 vaccine-related axillary adenopathy on breast imaging. All biopsies recommended within 12 weeks of the second vaccine dose were benign. Among women not recommended for biopsy, the median interval between the second vaccine dose and ultrasound follow-up was 15.9 weeks. Three biopsies yielding malignant diagnoses were recommended 12.0-13.1 weeks after the second vaccine dose. Lengthening imaging follow-up to 12-16 weeks after the second dose may reduce unnecessary biopsy recommendations.

Diversity and Inclusion in Breast Imaging and Radiology at Large: What Can We Do to Improve?

PURPOSE OF REVIEW: A racially and ethnically diverse healthcare workforce leads to increased access to care and better health outcomes. Radiology and specifically the patient-centered subspecialty of breast imaging have a growing mismatch between the demographics of the physician workforce and the patient population served. Identifying and addressing the barriers for diversity is imperative in order to decrease disparities in breast cancer morbidity and mortality and achieve excellence in patient care. RECENT FINDINGS: Three major barriers to promoting diversity and inclusion in the field of breast imaging and in the specialty of radiology more generally are unconscious bias, lack of mentorship for underrepresented minority (URM) students, and career development challenges facing women in radiology. We focus on these three issues and provide suggestions for addressing each of them. SUMMARY: Tackling unconscious bias through encouraging individual accountability and establishing implicit bias programs at the institutional level, supporting both formal and informal mentorship opportunities for URMs, and creating an environment to support women in leadership will bring us one step closer to fostering a diverse and inclusive breast imaging workforce and meeting the healthcare needs of the diverse US population.