Primary breast lymphoma: A single-institute experience in Taiwan

Abstract

Background:Breast is an uncommon location of lymphoma involvement. The most common type of primary breast lymphoma (PBL) is diffuse large B-cell lymphoma (DLBCL). Rituximab is the widely used monoclonal antibody against CD20+ B-cell lymphoma, especially DLBCL. We aimed to analyze the clinical features, prognostic factors, and treatment outcome with or without rituximab in primary breast DLBCL. Methods:We retrospectively analyzed patients diagnosed with PBL from October 1987 to March 2012 in our hospital, excluding metastasis by whole-body computed tomography and bone marrow study. Results:Twenty-three patients were diagnosed with PBL. All were females. Eighteen patients were stage IE and five were stage IIE according to the Ann Arbor staging system. Two patients had lymphoma other than DLBCL. The median age of primary breast DLBCL patients was 48 years (range 27-79). Two were excluded from the analysis due to refusal or ineligibility for chemotherapy. No significant prognostic factor was found. Patients receiving chemotherapy with (RC) or without (C) rituximab were not significantly different in the 5-year overall survival (RC: 57.1%; C: 58.3%; p = 0.457) or progression-free survival (RC: 57.1%; C: 50.0%; p = 0.456). A high incidence of relapse in the central nervous system (CNS) (17.6%) was observed. Conclusions: In accordance with prior literature reports, our Taiwanese cohort of primary breast DLBCL seemed younger than those reported in Japan, Korea, and Western societies. Relapse in the CNS was not uncommon. The benefit of rituximab in addition to chemotherapy was not statistically significant. Treatment modality remained to be defined by further large-scale studies. (Biomed J 2014;37:321-325)

Primary extranodal lymphoma of the glands. Literature review and options for best practice in 2019

“…At 10 years, actuarial OS was 50%, 50% and 76%, respectively (p<0.01) (Aviles et al, 2005). A positive impact of CMT +/-rituximab in PBL was also suggested in the more aggressive DLBCL subtype (Ou et al, 2014;Radkani, Joshi, Paramo, & Mesko, 2014).…”

“…The role of CNS prophylaxis in PBL is controversial. Case series have reported a high incidence of CNS recurrence at 5-17% or even higher if Burkitt's lymphoma was included (Ou et al, 2014;Ryan et al, 2008).…”

Primary breast diffuse large B‐cell lymphoma in the rituximab era: A retrospective study of the Chinese Southwest Oncology Group

“…Our study showed that relapse involving the CNS was a major cause of treatment failure for PB‐DLBCL patients, with a 5‐year cumulative CNS relapse incidence of 11.1%. Previous studies reported that CNS relapse occurred in 5%–17% of patients with PB‐DLBCL, and breast involvement is generally considered a high‐risk factor for CNS relapse 5,10,15,17,27,28 . Therefore, CNS prophylaxis is recommended for PB‐DLBCL by some guidelines 28 .…”

“…Previous studies reported that CNS relapse occurred in 5%–17% of patients with PB‐DLBCL, and breast involvement is generally considered a high‐risk factor for CNS relapse. 5 , 10 , 15 , 17 , 27 , 28 Therefore, CNS prophylaxis is recommended for PB‐DLBCL by some guidelines. 28 However, several retrospective series showed that IT prophylaxis did not decrease CNS relapse risk in patients with PB‐DLBCL.…”