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1.
In Vivo ; 36(3): 1333-1336, 2022.
Article in English | MEDLINE | ID: covidwho-1818960

ABSTRACT

BACKGROUND/AIM: COVID-19 vaccination is now performed in most of the world to limit the spread of the disease. The first mRNA vaccine was approved in clinical settings and has specific side effects including axillary lymph node swelling, which can be misdiagnosed as breast cancer metastasis. The timing of axillary lymph node swelling and its duration are unclear. Here, we present a Japanese case and review of the existing literature. CASE REPORT: We report the case of a 67-year-old woman with breast calcification. She had regular follow ups in our hospital for this calcification and received ultrasonography of the breast and axilla at every visit. She visited 6 months before having her COVID-19 vaccination, and 7 days and 6 months after the first COVID-19 vaccination. She had a swollen axillary lymph node 7 days after the first vaccination, which although it was improved, remained for 6 months. CONCLUSION: Axillary lymph node swelling occurred 7 days after vaccination and remained up to 6 months after it.


Subject(s)
Breast Neoplasms , COVID-19 , Neoplasms, Second Primary , Aged , Breast Neoplasms/pathology , COVID-19 Vaccines/adverse effects , Female , Humans , Japan , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Neoplasms, Second Primary/pathology , Vaccination/adverse effects , Vaccines, Synthetic
2.
Cancer Sci ; 113(4): 1531-1534, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1779205

ABSTRACT

According to the current international guidelines, high-risk patients diagnosed with pathological T1 (pT1) colorectal cancer (CRC) who underwent complete local resection but may have risk of developing lymph node metastasis (LNM) are recommended additional intestinal resection with lymph node dissection. However, around 90% of the patients without LNM are exposed to the risk of being overtreated due to the insufficient pathological criteria for risk stratification of LNM. Circulating tumor DNA (ctDNA) is a noninvasive biomarker for molecular residual disease and relapse detection after treatments including surgical and endoscopic resection of solid tumors. The CIRCULATE-Japan project includes a large-scale patient-screening registry of the GALAXY study to track ctDNA status of patients with stage II to IV or recurrent CRC that can be completely resected. Based on the CIRCULATE-Japan platform, we launched DENEB, a new prospective study, within the GALAXY study for patients with pT1 CRC who underwent complete local resection and were scheduled for additional intestinal resection with lymph node dissection based on the standard pathologic risk stratification criteria for LNM. The aim of this study is to explore the ability of predicting LNM using ctDNA analysis compared with the standard pathological criteria. The ctDNA assay will build new evidence to establish a noninvasive personalized diagnosis in patients, which will facilitate tailored/optimal treatment strategies for CRC patients.


Subject(s)
Circulating Tumor DNA , Colorectal Neoplasms , Circulating Tumor DNA/genetics , Colorectal Neoplasms/genetics , Colorectal Neoplasms/pathology , Colorectal Neoplasms/surgery , Humans , Liquid Biopsy , Lymph Node Excision , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Prospective Studies , Retrospective Studies , Risk Factors
3.
Chirurgia (Bucur) ; 117(1): 45-54, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1743108

ABSTRACT

Background: The novel coronavirus, SARS-COV-2, was first reported in Wuhan, China in the end of 2019. To curb its spread, social distancing measures and new safety regulations were implemented which led to major disruptions in colorectal cancer care. It is however unknown how it influenced the Romanian colorectal cancer care. Methods and Material: We assessed the demographical, clinical, intraoperative and pathological data of our colorectal cancer patients, 302 in total, between 15.03.2019-14.03.2021. The first year's data was considered as the control group and the second one, the study (pandemic) group. Results: We observed a 12% decrease in colorectal cancer hospitalizations in the first year, 38,6% in the first six months. The rate of emergency admissions, colo/ileostomy formatting procedures, palliative resections, clinical metastasis was higher in the pandemic group. More advanced locoregional invasion, a higher tumor stage, higher rate of vascular, perineural invasion, positive resection margin, and a higher lymph node yield was seen after the restrictions were implemented. Conclusion: The COVID-19 pandemic and the response against it had a major effect on the colorectal cancer care in our country. The outcomes of these worse clinical and pathological findings are unknown, but it is important to do further research in this field. We think colorectal cancer care should have an absolute priority in future pandemics.


Subject(s)
COVID-19 , Colorectal Neoplasms , COVID-19/epidemiology , Colorectal Neoplasms/epidemiology , Colorectal Neoplasms/pathology , Colorectal Neoplasms/surgery , Humans , Lymphatic Metastasis , Pandemics , Retrospective Studies , Romania/epidemiology , SARS-CoV-2 , Treatment Outcome
4.
In Vivo ; 36(2): 1041-1046, 2022.
Article in English | MEDLINE | ID: covidwho-1732571

ABSTRACT

BACKGROUND/AIM: COVID-19 started to spread as a pandemic in December 2019 and COVID-19 vaccination has been initiated worldwide. The efficacy of vaccination has been scientifically proven, but it might cause axillary lymph node swelling. To diagnose patients with axillary lymph node swelling caused by COVID-19 vaccination, we herein reviewed existing literature on this symptom. CASE REPORT: We report the case of a 70-year-old woman with a breast tumour. She had undergone cecum cancer surgery and regular computed tomography (CT). During breast tumour follow-up, she received scheduled CT that indicated severe axillary lymph node swelling mimicking breast cancer metastasis. We performed aspiration biopsy cytology of that lymph node, and determined this was not cancer metastasis but an effect of the COVID-19 vaccine. We confirmed this diagnosis at one month after computed tomography showed that the lymph node swelling had improved. CONCLUSION: Axillary lymph node swelling can occur after COVID-19 vaccination. Therefore, it is important to consider the effect of the COVID-19 vaccination on axillary lymph node swelling when diagnosing breast tumours.


Subject(s)
Breast Neoplasms , COVID-19 , Aged , Axilla/pathology , Breast Neoplasms/pathology , COVID-19 Vaccines/adverse effects , Female , Humans , Japan , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , SARS-CoV-2 , Sentinel Lymph Node Biopsy , Vaccination
5.
Clin Imaging ; 85: 78-82, 2022 May.
Article in English | MEDLINE | ID: covidwho-1708841

ABSTRACT

Metastatic melanoma of the breast is rare, and demonstrates nonspecific imaging findings which may overlap with both benign and malignant pathology.1-3 Immunohistochemical stains are important to confirm the diagnosis, particularly combining S100, a sensitive marker for melanoma, with more specific tumor markers such as Melan-A and HMB-45, and lack of cytokeratin staining.4-7 We present a case of a 64-year-old female who presented for diagnostic imaging of a palpable abnormality in her right breast, with medical history notable for previously excised cutaneous melanoma, recent COVID-19 vaccination, and significant family history of breast cancer. Diagnostic mammogram of the right breast demonstrated a circumscribed mass in the lower inner quadrant corresponding to the area of palpable concern, as well as an additional non-palpable circumscribed mass in the lower inner quadrant. Targeted right breast ultrasound demonstrated corresponding circumscribed cystic versus solid masses as well as a morphologically abnormal right axillary lymph node. Pathologic results after tissue sampling of the two right breast masses and right axillary lymph node all yielded metastatic melanoma.


Subject(s)
Breast Neoplasms , COVID-19 , Melanoma , Skin Neoplasms , Axilla/pathology , Breast Neoplasms/pathology , COVID-19 Vaccines , Female , Humans , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Melanoma/diagnostic imaging , Melanoma/pathology , Middle Aged , Skin Neoplasms/diagnostic imaging , Skin Neoplasms/pathology
6.
Breast Cancer Res Treat ; 191(3): 677-683, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1616181

ABSTRACT

PURPOSE: Non-specific lymphadenopathy is increasingly being reported especially given the COVID-19 vaccination campaign and is a diagnostic dilemma especially in oncology patients. The purpose of this study was to evaluate the diagnostic accuracy and discordance rate between fine-needle aspiration (FNA) cytology and flow cytometry (FC) immunophenotyping in axillary FNA in patients with morphologically abnormal axillary lymph nodes on imaging and no concurrent diagnosis of primary breast malignancy. METHODS: This retrospective study included 222 patients who underwent screening or diagnostic axillary ultrasound that yielded suspicious lymphadenopathy without concurrent or recent prior diagnosis of breast cancer and who had subsequent image-guided axillary FNA and FC. Diagnostic accuracy, sensitivity, specificity, and positive and negative predictive value (PPV and NPV) were reported for FNA with cytology alone, and FC alone, and in combination. Discordance rate between FNA cytology and FC was assessed. Discordant cases were evaluated with histology or clinical and imaging follow-up. RESULTS: Diagnostic sensitivity, specificity, PPV, NPV, and diagnostic accuracy were 88%, 92%, 77%, 96%, and 91%, for FNA alone, 98%, 98%, 92%, 99%, and 98% for FC alone, and 100%, 92%, 79%, 100%, and 94% when combined. The overall discordance rate between FNA and FC was 7% (16/222). 7/16 (44%) patients with discordant results were diagnosed with lymphoma, while 9/16 (56%) patients with discordant results had benign findings. CONCLUSION: With a diagnostic accuracy of 91%, FNA with cytology is sufficient to screen patients with indeterminate and incidental lymphadenopathy. Flow cytometry could be initially deferred in patients with low pretest probability of lymphoma.


Subject(s)
Breast Neoplasms , COVID-19 , Lymphadenopathy , Breast Neoplasms/diagnosis , COVID-19 Vaccines , Female , Flow Cytometry , Humans , Lymph Nodes , Lymphatic Metastasis , Retrospective Studies , SARS-CoV-2 , Sensitivity and Specificity
7.
Immunol Med ; 45(1): 45-47, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1585214

ABSTRACT

Western countries that were first to administer the COVID-19 vaccination report cases of vaccine-induced axillary lymphadenitis with high FDG uptake. However, no such findings have been reported from any Asian countries. We report here a confusing case of a 31-year-old female cancer survivor with high FDG uptake in her axillary lymph nodes, suggesting recurrence, following mRNA COVID-19 vaccination. Although the value of SUVmax was elevated (12.7), additional imaging revealed that her lymphatic lesions were benign, and they resolved spontaneously. This case of a strong immune reaction to COVID-19 vaccination in regional lymph nodes is the first reported in a Japanese patient. We should be aware of this new mimic and optimize diagnostic imaging methods accordingly in the era of COVID-19.


Subject(s)
COVID-19 , Cancer Survivors , Lymphadenitis , Adult , COVID-19 Vaccines , Female , Fluorodeoxyglucose F18 , Humans , Lymphadenitis/chemically induced , Lymphadenitis/diagnosis , Lymphatic Metastasis , Neoplasm Recurrence, Local , RNA, Messenger , SARS-CoV-2
8.
Chest ; 160(6): e645-e650, 2021 12.
Article in English | MEDLINE | ID: covidwho-1544869

ABSTRACT

CASE PRESENTATION: A 30-year-old man with a history of childhood asthma, a 15-pack-year smoking history, and methamphetamine abuse was intubated and started on mechanical ventilation because of acute hypoxic respiratory failure after experiencing progressive dyspnea and a nonproductive cough over the previous year. During the previous 3 months, he had multiple clinic visits, with chest radiographs showing diffuse, bilateral, reticulonodular opacities and small bilateral pleural effusions and was treated for community-acquired pneumonia. Testing for COVID pneumonia was negative, and he failed to respond to antimicrobial therapy. Physical examination on admission showed diffuse fine crackles bilaterally on lung auscultation. Admission laboratory test results were unremarkable.


Subject(s)
Adenocarcinoma/diagnosis , Carcinoma/diagnosis , Lung Neoplasms/diagnosis , Lymphangitis/diagnosis , Adenocarcinoma/pathology , Adrenal Gland Neoplasms/secondary , Adult , Biomarkers, Tumor/analysis , Carcinoma/pathology , Diagnosis, Differential , Dyspnea , Fatal Outcome , Humans , Lung Neoplasms/pathology , Lymphangitis/pathology , Lymphatic Metastasis , Male , Neoplasm Invasiveness , Tomography, X-Ray Computed
9.
BMJ Case Rep ; 14(11)2021 Nov 17.
Article in English | MEDLINE | ID: covidwho-1522932

ABSTRACT

Follicular dendritic cell sarcoma is a rare low-grade sarcoma of mesenchymal origin. It involves the lymph nodes more commonly and rarely extranodal sites. The most common lymph node is cervical and usually presents as a painless asymptomatic mass. More often, it is a misdiagnosis, and there is a delay in treatment. It is rarely associated with Castleman disease, myasthenia gravis. Diagnosis of this condition is by histopathology and immunochemistry. Surgery is the primary modality of treatment, and adjuvant therapy has been tried with no definite trials due to the rarity of the disease. Here, we report a case of concomitant follicular dendritic sarcoma of the right cervical lymph node and papillary carcinoma of the thyroid managed in our institute. There was a line of investigations approaching towards a diagnosis, and she underwent total thyroidectomy and right modified radical neck dissection.


Subject(s)
Carcinoma, Papillary , Dendritic Cell Sarcoma, Follicular , Thyroid Neoplasms , Carcinoma, Papillary/surgery , Dendritic Cell Sarcoma, Follicular/diagnostic imaging , Dendritic Cell Sarcoma, Follicular/surgery , Female , Humans , Lymph Nodes/diagnostic imaging , Lymph Nodes/surgery , Lymphatic Metastasis , Neck Dissection , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/surgery , Thyroidectomy
10.
Clin Nucl Med ; 46(12): 1011-1012, 2021 Dec 01.
Article in English | MEDLINE | ID: covidwho-1501244

ABSTRACT

ABSTRACT: A 50-year-old woman with stage IV sigmoid adenocarcinoma presented for restaging FDG PET/CT status post neoadjuvant chemotherapy/immunotherapy and diverting sigmoid colostomy. FDG PET/CT demonstrated FDG uptake in the known sigmoid mass and in abdominopelvic lymph node metastases. Bilateral, asymmetric, hypermetabolic axillary lymphadenopathy was also observed, an atypical pattern of spread for colon cancer. Further investigation revealed the patient had received both doses of COVID-19 vaccine in the 2 months prior to presentation. The authors discuss immunogenic nodal hypermetabolism following vaccination against COVID-19 and incorporating vaccination history to aid in PET/CT interpretation, especially in malignancies involving the axillae.


Subject(s)
COVID-19 , Lymphadenopathy , COVID-19 Vaccines , Female , Fluorodeoxyglucose F18 , Humans , Lymphadenopathy/diagnostic imaging , Lymphatic Metastasis , Middle Aged , Positron Emission Tomography Computed Tomography , SARS-CoV-2 , Vaccination
11.
Am J Otolaryngol ; 43(1): 103263, 2022.
Article in English | MEDLINE | ID: covidwho-1469812

ABSTRACT

OBJECTIVES: During the COVID-19 pandemic, maintenance of safe and timely oncologic care has been challenging. The goal of this study is to compare presenting symptoms, staging, and treatment of head and neck mucosal squamous cell carcinoma during the pandemic with an analogous timeframe one year prior. MATERIALS AND METHODS: Retrospective cohort study at a single tertiary academic center of new adult patients evaluated in a head and neck surgical oncology clinic from March -July 2019 (pre-pandemic control) and March - July 2020 (COVID-19 pandemic). RESULTS: During the pandemic, the proportion of patients with newly diagnosed malignancies increased by 5%, while the overall number of new patients decreased (n = 575) compared to the control year (n = 776). For patients with mucosal squamous cell carcinoma (SCC), median time from referral to initial clinic visit decreased from 11 days (2019) to 8 days (2020) (p = 0.0031). There was no significant difference in total number (p = 0.914) or duration (p = 0.872) of symptoms. During the pandemic, patients were more likely to present with regional nodal metastases (adjusted odds ratio (OR) 2.846, 95% CI 1.072-3.219, p = 0.028) and more advanced clinical nodal (N) staging (p = 0.011). No significant difference was seen for clinical tumor (T) (p = 0.502) or metastasis (M) staging (p = 0.278). No significant difference in pathologic T (p = 0.665), or N staging (p = 0.907) was found between the two periods. CONCLUSION: Head and neck mucosal SCC patients presented with more advanced clinical nodal disease during the early months of the COVID-19 pandemic despite no change in presenting symptoms.


Subject(s)
COVID-19/epidemiology , Squamous Cell Carcinoma of Head and Neck/epidemiology , Squamous Cell Carcinoma of Head and Neck/pathology , Aged , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Pandemics , Retrospective Studies , SARS-CoV-2 , Squamous Cell Carcinoma of Head and Neck/therapy , Tennessee/epidemiology
12.
Eur Radiol ; 32(3): 1644-1651, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1465860

ABSTRACT

OBJECTIVES: Due to COVID-19, a lockdown took place between March 17 and May 1, 2020, in France. This study evaluates the impact of the lockdown on the diagnosis and staging of breast cancers in a tertiary cancer centre. METHODS: Our database was searched for all consecutive invasive breast cancers diagnosed in our institution during the lockdown (36 working days), during equivalent periods of 36 working days before and after lockdown and a reference period in 2019. The number and staging of breast cancers diagnosed during and after lockdown were compared to the pre-lockdown and reference periods. Tumour maximum diameters were compared using the Mann-Whitney test. Proportions of tumour size categories (T), ipsilateral axillary lymph node invasion (N) and presence of distant metastasis (M) were compared using Fisher's exact test. RESULTS: Compared to the reference period (n = 40 in average), the number of breast cancers diagnosed during lockdown (n = 32) decreased by 20% but increased by 48% after the lockdown (n = 59). After the lockdown, comparatively to the reference period, breast cancers were more often symptomatic (86% vs 57%; p = 0.001) and demonstrated bigger tumour sizes (p = 0.0008), the rates of small tumours (T1) were reduced by 38%, locally advanced cancers (T3, T4) increased by 80% and lymph node invasion increased by 64%. CONCLUSION: The COVID-19 lockdown was associated with a 20% decrease in the number of diagnosed breast cancers. Because of delayed diagnosis, breast cancers detected after the lockdown had poorer prognosis with bigger tumour sizes and higher rates of node invasion. KEY POINTS: • The number of breast cancer diagnosed in a large tertiary cancer centre in France decreased by 20% during the first COVID-19 lockdown. • Because of delayed diagnosis, breast cancers demonstrated bigger tumour size and more frequent axillary lymph node invasion after the lockdown. • In case of a new lockdown, breast screening programme and follow-up examinations should not be suspended and patients with clinical symptoms should be encouraged to seek attention promptly.


Subject(s)
Breast Neoplasms , COVID-19 , Axilla/pathology , Breast Neoplasms/epidemiology , Breast Neoplasms/pathology , Communicable Disease Control , Female , Humans , Lymphatic Metastasis , Neoplasm Staging , SARS-CoV-2
13.
Melanoma Res ; 31(5): 490-493, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1371755

ABSTRACT

COVID-19 vaccination has been rapidly implemented among patients with cancer. We present the case of a patient with high-risk resected cutaneous melanoma, who was a candidate for adjuvant treatment, with postsurgery 18-fluorodeoxyglucose (FDG) PET/computed tomography (CT) scan showing positive axillary lymph nodes after COVID-19 vaccination. This report presents a 50-year-old man with a history of stage IIA cutaneous melanoma. During follow-up, the patient experienced subcutaneous and lymph-node disease progression, documented with 18FDG PET/CT scan. The patient underwent laparoscopic left para-aortic lymphadenectomy and excision of subcutaneous lesion. Histologic examination showed presence of melanoma metastases in 2 lymph nodes out of total 17 excised and neoplastic emboli to the subcutaneous tissue. In view of starting adjuvant nivolumab, the patient underwent CT scan restaging, with evidence of suspect centimetric periaortic and paracaval lymph nodes, which were deemed worthy of 18FDG PET investigation. The 18FDG PET/CT was negative for abdominal hypercaptation, but showed left axillary pathologic lymph nodes. The medical history of the patient revealed that he had received intramuscular Moderna COVID-19 mRNA vaccine in the left deltoid, one week before 18FDG PET examination. Since the patient's clinical examination was negative and suspecting postvaccination false-positive adenopathy, bilateral axillary ultrasound was performed, excluding the presence of pathologic lymph nodes. The patient has started adjuvant treatment with nivolumab, which is currently ongoing. This case demonstrates unexpected findings in response to COVID-19 vaccination in a patient with melanoma. In this specific case, the detection of 18FDG PET hypercaptation could significantly change the patient's management. With growing evidence about the pattern and occurrence of adenopathies after mRNA COVID-19 vaccination, recommendations for scheduling and interpretation of 18FDG PET/CT scans among cancer patients will be implemented, in order to reduce equivocal findings and improve outcomes.


Subject(s)
COVID-19 Vaccines/adverse effects , Lymph Nodes/pathology , Melanoma/pathology , COVID-19 Vaccines/administration & dosage , Disease Progression , Humans , Lymph Nodes/diagnostic imaging , Lymphatic Metastasis , Male , Melanoma/diagnostic imaging , Middle Aged
15.
Eur J Cancer ; 154: 167-174, 2021 09.
Article in English | MEDLINE | ID: covidwho-1316471

ABSTRACT

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has changed the lives of people around the world. Fortunately, sufficient vaccines are now available. Local reactions with ipsilateral lymphadenopathy are among the most common side effects. We investigated the impact of lymphadenopathy after COVID-19 vaccination on the value of ultrasound in tumour patients. PATIENTS AND METHODS: Patients with melanoma or Merkel cell carcinoma were included who underwent lymph node excision and received COVID-19 vaccination within 6 weeks before surgery. The consistency of the preoperative ultrasound findings with the histopathologic findings was investigated. RESULTS: Eight patients were included (two Merkel cell carcinoma and six melanoma patients) who underwent lymph node excision between 16th April 2021 and 19th May 2021 and had previously received COVID-19 vaccination. In three of the eight patients (one Merkel cell carcinoma and two melanoma patients), lymph node metastases were erroneously diagnosed preoperatively during tumour follow-up with physical examination, ultrasound, and or fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT). In these three patients, the suspected lymph node metastases were located in the left axilla after COVID-19 vaccination in the left upper arm, which resulted in selective lymph node removal in two patients and complete lymphadenectomy in one patient. CONCLUSION: COVID-19 vaccine-associated lymphadenopathy is expected to be observed much more frequently in the near future because of increasing vaccination rates. This cause of lymphadenopathy, which may in ultrasound as well as in FDG PET/CT resemble lymph node metastases, must be considered, especially in oncologic patients undergoing tumour follow-up. In addition, COVID-19 vaccination should be given as far away as possible from an underlying primary on the contralateral side to avoid oncologic misdiagnosis followed by malpractice.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Carcinoma, Merkel Cell/secondary , Lymph Nodes/drug effects , Lymphadenopathy/chemically induced , Melanoma/secondary , Skin Neoplasms/pathology , Vaccination/adverse effects , Adult , Aged , Aged, 80 and over , COVID-19/immunology , COVID-19/virology , COVID-19 Vaccines/administration & dosage , Diagnosis, Differential , Diagnostic Errors , Female , Germany , Humans , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Lymphadenopathy/diagnostic imaging , Lymphatic Metastasis , Male , Middle Aged , Predictive Value of Tests , Treatment Outcome , Ultrasonography
16.
Radiology ; 300(1): E296-E300, 2021 07.
Article in English | MEDLINE | ID: covidwho-1280491

ABSTRACT

Five cases of axillary lymphadenopathy are presented, which occurred after COVID-19 vaccination and mimicked metastasis in a vulnerable oncologic patient group. Initial radiologic diagnosis raised concerns for metastasis. However, further investigation revealed that patients received COVID-19 vaccinations in the ipsilateral arm prior to imaging. In two cases, lymph node biopsy results confirmed vaccination-related reactive lymphadenopathy. Ipsilateral axillary swelling or lymphadenopathy was reported based on symptoms and physical examination in COVID-19 vaccine trials. Knowledge of the potential for COVID-19 vaccine-related ipsilateral adenopathy is necessary to avoid unnecessary biopsy and change in therapy. © RSNA, 2021.


Subject(s)
Breast Neoplasms/pathology , COVID-19 Vaccines/adverse effects , Liposarcoma, Myxoid/pathology , Lymphadenopathy/diagnostic imaging , Lymphadenopathy/etiology , Lymphatic Metastasis/diagnosis , Melanoma/pathology , Adult , COVID-19/prevention & control , Diagnosis, Differential , Female , Humans , Lymph Nodes/diagnostic imaging , Male , Middle Aged , Positron Emission Tomography Computed Tomography/methods , SARS-CoV-2
17.
J Surg Oncol ; 124(3): 261-267, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1272214

ABSTRACT

OBJECTIVE: At the end of 1 year of the coronavirus disease (COVID-19) pandemic, we aimed to reveal the changes in breast cancer cases in the context of cause and effect based on the data of surgically treated patients in our institution. PATIENTS AND METHODS: Patients with breast cancer were divided into two groups. Group 1 consisted of patients who were operated in the year before the COVID-19 pandemic, and Group 2 consisted of patients who were operated within the first year of the pandemic. Tumor size, axillary lymph node positivity, distant organ metastasis status, neoadjuvant chemotherapy, and type of surgery performed were compared between the two groups. RESULTS: The tumor size, axillary lymph node positivity, and neoadjuvant chemotherapy were higher in Group 2 than in Group 1 (p = .005, p = .012, p = .042, respectively). In addition, the number of breast-conserving surgery + sentinel lymph node biopsy were lower, while the number of mastectomy and modified radical mastectomy were higher in Group 2 than in Group 1 (p = .034). CONCLUSION: Patients presented with larger breast tumors and increased axillary involvement during the pandemic. Moreover, distant organ metastases may increase in the future.


Subject(s)
Breast Neoplasms/diagnosis , COVID-19 , Delayed Diagnosis/trends , Health Services Accessibility/trends , Patient Acceptance of Health Care/statistics & numerical data , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/therapeutic use , Breast Neoplasms/drug therapy , Breast Neoplasms/pathology , Breast Neoplasms/surgery , Chemotherapy, Adjuvant , Female , Humans , Lymph Node Excision/trends , Lymphatic Metastasis , Mastectomy/methods , Mastectomy/trends , Middle Aged , Neoadjuvant Therapy , Retrospective Studies , Tumor Burden , Turkey
18.
Gynecol Oncol ; 161(2): 414-421, 2021 05.
Article in English | MEDLINE | ID: covidwho-1151485

ABSTRACT

OBJECTIVE: The current coronavirus pandemic caused a significant decrease in cancer-related encounters resulting in a delay in treatment of cancer patients. The objective of this study was to examine the survival effect of delay in starting concurrent chemo-radiotherapy (CCRT) in women with locally-advanced cervical cancer. METHODS: This is a retrospective observational study querying the National Cancer Database from 2004 to 2016. Women with stage IB2-IVA squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma of the uterine cervix who received definitive CCRT with known wait-time for CCRT initiation after cancer diagnosis were eligible (N=13,617). Cox proportional hazard regression model with restricted cubic spline transformation was fitted to assess the association between CCRT wait-time and all-cause mortality in multivariable analysis. RESULTS: The median wait-time to start CCRT was 6 (IQR 4-8) weeks. In a multivariable analysis, older age, non-Hispanic black and Hispanic ethnicity, recent year of diagnosis, Medicaid and uninsured status, medical comorbidities, and absence of nodal metastasis were associated with longer CCRT wait-time (P<.05). Women with aggressive tumor factors (poorer differentiation, large tumor size, nodal metastasis, and higher cancer stage) were more likely to have a short CCRT wait-time (P<.05). After controlling for the measured covariates, CCRT wait-time of 6.1-9.8 weeks was not associated with increased risk of all-cause mortality compared to a wait-time of 6 weeks. Similar association was observed when the cohort was stratified by histology, cancer stage, tumor size, or brachytherapy use. CONCLUSION: An implication of this study for the current coronavirus pandemic is that in the absence of aggressive tumor factors, a short period of wait-time to start definitive CCRT may not be associated with increased risk of mortality in women with locally-advanced cervical cancer.


Subject(s)
Adenocarcinoma/therapy , COVID-19 , Carcinoma, Adenosquamous/therapy , Carcinoma, Squamous Cell/therapy , Time-to-Treatment , Uterine Cervical Neoplasms/therapy , Adenocarcinoma/secondary , Adult , African Americans/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , COVID-19/epidemiology , Carcinoma, Adenosquamous/secondary , Carcinoma, Squamous Cell/secondary , Chemoradiotherapy , Female , Humans , Lymphatic Metastasis , Medicaid/statistics & numerical data , Medically Uninsured/statistics & numerical data , Middle Aged , Neoplasm Grading , Neoplasm Staging , Proportional Hazards Models , Race Factors , Retrospective Studies , SARS-CoV-2 , Survival Rate , Tumor Burden , United States , Uterine Cervical Neoplasms/pathology
19.
J Plast Reconstr Aesthet Surg ; 74(10): 2776-2820, 2021 10.
Article in English | MEDLINE | ID: covidwho-1252517

ABSTRACT

INTRODUCTION: Axillary sentinel node biopsy for melanoma is routinely performed under general anaesthesia. Emerging evidence has shown general anaesthetics are associated with increased mortality in the context of the COVID-19 pandemic. In the interest of patient safety, we have designed a series of bespoke axillary regional blocks enabling surgeons to remove nodes up to and including level III without the need for a general anaesthetic. The aim of this study was to assess the feasibility of performing axillary sentinel node biopsy under such blocks. METHODS: Approval was granted by the Joint Study Review Committee on behalf of the Research and Ethics Department. Ten consecutive patients having axillary sentinel node biopsy for melanoma were included in this prospective study. Patients completed a Quality of Recovery-15 (QoR15) questionnaire preoperatively and 24 h postoperatively. DISCUSSION: One patient had a positive sentinel node, the remining were negative. A significant reduction in time spent in hospital post-operatively (p = 0.0008) was observed. QoR15 patient reported outcome measures demonstrated high levels of satisfaction evidenced by lack of statistical difference between pre and post-operative scores (p = 0.0118). 80% of patients were happy to have a regional block and 90% were happy to attend hospital during the pandemic. CONCLUSION: ASNB under regional block is safe, negates risks associated with performing GAs during the COVID-19 pandemic and facilitates quicker theatre turnover and discharge from hospital. Collaboration between anaesthetic and surgical teams has enabled this change in practice. There is a learning curve with both patient selection, education and development of technique.


Subject(s)
Anesthesia, Conduction/methods , COVID-19/epidemiology , Lymph Nodes/surgery , Melanoma/secondary , Sentinel Lymph Node Biopsy/methods , Skin Neoplasms/pathology , Axilla , Comorbidity , Global Health , Humans , Lymph Node Excision/methods , Lymphatic Metastasis , Melanoma/diagnosis , Melanoma/epidemiology , Pandemics , Skin Neoplasms/epidemiology
20.
Anticancer Res ; 41(5): 2689-2696, 2021 May.
Article in English | MEDLINE | ID: covidwho-1218756

ABSTRACT

BACKGROUND/AIM: The COVID-19 lockdown includes restrictive measures and temporary health system reorganization. Resources were shifted to COVID-19 patients, screening programs were temporary suspended, and oncological care suffered slow-down. The aim of the study was to evaluate the impact of these measures on breast cancer patients. PATIENTS AND METHODS: All breast cancer patients referred to our unit from February 21, 2019 to February 21, 2021 were enrolled. Type of treatments and surgery, TNM, tumor diameter, and predictive and prognostic factors were analyzed. RESULTS: Out of 445 patients with a breast cancer diagnosis, 182 (40.9%) were enrolled in the COVID-19 group (from February 21, 2010 to February 21, 2021). These patients were compared with 263 (59.1%) patients pre-COVID-19. Tumor diameters were bigger in the COVID-19 group. Type of surgery and N staging were statistically significantly different. Extreme advanced disease incidence was significantly different between the groups (2.7% COVID-19 group vs. 0 pre-COVID-19 group, p=0.011). Incidence of post-surgical radiation-therapy was higher in the COVID-19 group. Other variables analyzed were comparable without a statistically significant difference. CONCLUSION: COVID-19 led to increased tumor dimensions, advanced N-staging, and increased need for adjuvant treatments in breast cancer.


Subject(s)
Breast Neoplasms/pathology , Breast Neoplasms/therapy , COVID-19/epidemiology , Adult , Aged , Aged, 80 and over , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , COVID-19/prevention & control , COVID-19/psychology , Combined Modality Therapy , Female , Humans , Incidence , Lymphatic Metastasis , Male , Mastectomy , Middle Aged , Neoplasm Staging , Retrospective Studies , SARS-CoV-2 , Time-to-Treatment , Tumor Burden
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