Primary breast lymphoma: a report of 20 cases

Abstract

Summary. Limited data are available concerning treatment and outcome of primary lymphoma of the breast (PLB), especially after CHOP (cyclophosphamide, hydroxydoxorubicin, vincristine, prednisone) chemotherapy. We retrospectively reviewed 20 consecutive cases of localized PLB seen at our institution over a 20 year period. All PLB were of B-cell origin: treatment was CHOP or a CHOP-like regimen in all patients. Sixteen of the 20 patients achieved complete remission (CR) and two achieved partial remission (. 75% tumour regression). Two patients had progressive disease on therapy. With a median follow-up of 54 months, six patients relapsed after 8±66 months. Two of the relapses involved the central nervous system (CNS) (isolated in one case, associated with other sites of relapse in the other). The two patients who achieved partial remission also had progression in the CNS, 4 and 8 months after the end of CHOP chemotherapy. All four patients have died as a result of their disease 3, 6, 10 and 13 months after CNS relapse. Of the 16 centroblastic diffuse large B-cell lymphoma (DLCL), three had CNS disease at relapse. We also observed three (15%) controlateral breast relapses. Thirteen of the initial 20 patients are alive in CR, six patients have died as a result of their lymphoma and one of unrelated disease. In conclusion, we observed a high incidence of CNS relapse in this group of localized extranodal lymphoma, strongly suggesting that CNS prophylaxis should be associated with systemic chemotherapy in localized PLB.

Rituximab and dose dense chemotherapy in primary breast lymphoma

“…Twenty-eight patients completed the program, four patients received only 5 cycles for progression. Twelve patients relapsed: lung (5), lung, bone marrow and nodal disease (4), lung, bone and bone marrow (3). Relapse at the central nervous system (CNS) was not observed.…”

“…Prognostic factors such as age, IPI, stage, levels of LDH and tumor size have been considered to predict outcome in PBL. 3,6,7 But our patients presented low clinical risk, uniform age performance status and tumor size, with normal levels of LDH in most cases. They were, therefore, considered to have a good prognosis.…”

“…Generally, reports included small numbers of patients and treatment has been retrospectively analyzed. [1][2][3][4][5][6][7] There is still no standard universal management. Most studies agree that combined therapy: anthracycline-based chemotherapy and radiotherapy (involved field) is the best therapeutic schedule in patients with PBL.…”

Primary Mammary (Non-Hodgkin) Lymphoma of Breast: A Case Report

“…Most Clinicians agree that multimodality treatment is necessary [10,15,16]. However, recent studies have shown that aggressive B-cell lymphomas should always be treated with chemotherapy alone or in combination with radiotherapy [10,15,17,18].…”

Primary Non-Hodgkin Lymphoma of the Breast- A Rare Case Report

“…[12] The treatment of primary non-Hodgkin lymphoma of breast is similar to that given for systemic lymphomas of similar histological type. Most clinicians agree that multimodality treatment is necessary, [9,13,14] comprised of wide local excision or mastectomy with lymph node dissection and CHOP regimen of chemotherapy with or without radiotherapy. However chemotherapy without mastectomy has good outcome.…”