Armpit Swelling After COVID-19 Vaccine May Mimic Breast Cancer

Axillary adenopathy, or swelling under the armpit, has been reported by women after receiving the Pfizer and Moderna COVID-19 vaccines, but it is also a common symptom for breast cancer.

...clinicians should consider recent COVID-19 vaccination history in the differential diagnosis of patients who present with unilateral axillary adenopathy, according to a new article.

In an article published in Clinical Imaging, Dodelzon and colleagues describe four cases involving women who received a COVID-19 vaccine and then sought breast screening. In describing these cases, the authors sought "to inform the medical community to consider this benign and self-resolving diagnosis in the setting of what can be alarming presentation of unilateral axillary adenopathy.

They hope they will decrease unnecessary biopsies and help reassure patients.

https://www.medscape.com/viewarticle/946448?src=mk...

{Free access to reporting. Registration may be required.}

COVID Relief Bill Contains Lots of Healthcare Provisions

— Includes new incentives for states that haven't expanded Medicaid

For those (in the US) who rely on COBRA, ACA plans or Medicaid for health insurance coverage, this article provides a brief but helpful summary of how coverage is likely to be affected. This includes subsidies and relief from the high cost of coverage for many.

https://www.medpagetoday.com/infectiousdisease/cov...

{Free access but registration my be required.}

'An accelerated cauldron of evolution': Covid-19 patients with cancer, HIV, may play a role in emergence of variants

Some hospitalized patients with weakened immune systems were shown to have mutating viruses months before the variants were discovered in the outside world

March 11, 2021

{A case report} is one of about 15 similar ones involving immunocompromised patients and recently published in medical journals or preprint servers that have become an important puzzle piece for researchers seeking to understand the origins of the coronavirus variants taking over the world. Those reports lend support to an intriguing theory that some individuals with weakened immune systems due to cancer, HIV or other illnesses may act as incubators for new mutations — an idea bolstered by the astonishing fact that the B.1.1.7 variant, first recognized in the United Kingdom, and B. 1.351, from South Africa, were found in some hospitalized patients months before their discovery in the outside world.

"The evidence points to these immunocompromised patients as an accelerated cauldron of evolution," said David Pollock, a professor of genomics at the University of Colorado School of Medicine.

...the cases have triggered intense debate about how to best manage immunocompromised patients with the coronavirus — whether additional testing or sequencing should be more routine, different isolation procedures considered and alternate treatment protocols followed.

...One of the biggest questions facing doctors treating coronavirus patients with weakened immune systems is how the combination of therapies for SARS-CoV-2 and for cancer, or other underlying illnesses, affect viral mutation.

"I will tell you, to be completely honest, we don't know the best thing to do," Haidar said.

...One common thread among those reported to have prolonged covid-19 infections is a deficiency in what are known as B cells, which produce virus-attacking antibodies — a situation that may allow the virus to replicate with abandon.

According to preliminary findings posted March 2 while a paper is under peer review, Jennifer Dien Bard, who runs the virology lab at Children's Hospital Los Angeles, and her colleagues described seeing two patients with such a condition who kept returning to the hospital and who had persistently positive coronavirus tests with high viral loads.

...The evidence strongly suggests that a patient's inability to mount an immune response "plays a significant role in allowing the virus to really thrive and replicate," she said. Still, she noted, "these are two interesting cases among hundreds of other cases. The likelihood of this happening even to immunocompromised patients is rare and low."

https://www.washingtonpost.com/health/2021/03/11/i...

{Article from Washington Post. Highlights, rather than the entire article, are included owing to length and copyright considerations. If you have questions, PM me. Note that patients discussed in this article had HIV, lymphoma, leukemia and potentially organ transplants. None was noted to be a breast cancer patient and specific chemotherapeutic regimens were not discussed in detail.}

Additional coverage of similar topic, primarily related to organ transplant patients, can be found here:

https://www.medpagetoday.com/infectiousdisease/vac...

{If anyone is aware of studies examining immune response to covid vaccines among those undergoing chemotherapy, I would love to hear about that!}