Lymphoma of the breast: A clinicopathologic analysis of 51 cases with a specific emphasis on patients with a history of breast carcinoma

Abstract

Breast lymphoma (BL) is a rare entity representing 1%-2% of breast malignancies while being the most common extra-mammary cancer involving the breast. It primarily affects postmenopausal women with a similar clinical presentation as breast carcinoma. It is classified into two main categories: primary breast lymphoma (PBL), and secondary breast lymphoma (SBL) as part of systemic disease. Bilateral breast involvement is not an uncommon situation and was reported in 0%-25% of patients with PBL in the previous series. Overall, the most common histologic subtype is diffuse large B-cell lymphoma (DLBCL), followed by extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and follicular lymphoma. 1,2 The prevalence of a history of breast carcinoma (BC) in patients with BL was not well documented and reported mostly as single case reports. The recommended treatment modality for patients with BL differs from BC and includes chemotherapy ± radiotherapy. When a definitive diagnosis and pathologic subtyping of BL are made on core biopsy, surgery is usually not recommended and has no impact on survival in most cases. A variety of clinical and pathologic characteristics such as age, stage, type of treatment, or pathologic subtype were observed to impact the prognosis of patients with BL. 1,2 However, the significance of history of BC for the prognosis of BL has not been explored in previous studies. In this study, we aimed to report a single health care system experience in BL with a specific focus on patients with a history of BC. | ME THODSAfter obtaining approval from the Northwell Health Institutional Review Board, our health system's pathology database was searched from January 1, 2010, to July 31, 2020, for lymphoid neoplasms involving the breast that were diagnosed on core needle biopsy, excision, mastectomy, or implant removal. Clinical, radiology, and pathology notes were reviewed to note the following: age, sex, history of BC, axillary involvement, side of involvement, radiologic characteristics and size, BIRADS score, type of procedure, pathological

Breast involvement of hematological malignancies: imaging and clinical findings

“…No marked difference was observed between primary and secondary breast involvement of hematological malignancies except that bilaterality was only seen in secondary involvement. Similar to these findings, Genco et al also reported no significant difference between patients with primary and secondary breast lymphoma [7]. The most common presenting symptoms were neck and axillary masses before breast involvement in the cases with secondary diseases, while the patients with primary breast lymphoma did not have any symptoms except breast or axillary masses.…”

Primary diffuse large B-cell lymphoma of the breast

“…Average age of the cases was 59.13 years, while there was only one male among the 32 patients in this study, that was similar to Genco et al’s study. 7 Our results indicated that the 5-year PFS in patients with DLBCL of the breast was 44% and the OS was 49%. This study also showed that 5 year survival time was not related to age, tumour site, tumour size, IPI score, B symptoms, pathological origin, metastasis, comorbidities, or IR.…”

Vav1 Promotes B-Cell Lymphoma Development

“…One possible example is that of Mucosa-associated lymphoid tissue (MALT) lymphomas that originate in sites of chronic epithelial inflammation in various sites of the body, where it plays a role in regulating mucosal immunity [41]. MALT lymphomas are present in the gastrointestinal tract [42], nasopharynx [43], thyroid [44], breast [45], lung [46], salivary glands [47], eye [48], and skin [49] and exhibit characteristics with B cells located in the marginal zone of lymph node follicles. MALT lymphomas originate in sites of chronic epithelial inflammation.…”