Primary breast lymphoma: Patient profile, outcome and prognostic factors. A multicentre Rare Cancer Network study

Centre Hospitalier Universitaire Vaudois and University of Lausanne, Rue du Bugnon, CH-1011 Lausanne, Switzerland.
BMC Cancer (Impact Factor: 3.36). 02/2008; 8(1):86. DOI: 10.1186/1471-2407-8-86
Source: PubMed


To asses the clinical profile, treatment outcome and prognostic factors in primary breast lymphoma (PBL).
Between 1970 and 2000, 84 consecutive patients with PBL were treated in 20 institutions of the Rare Cancer Network. Forty-six patients had Ann Arbor stage IE, 33 stage IIE, 1 stage IIIE, 2 stage IVE and 2 an unknown stage. Twenty-one underwent a mastectomy, 39 conservative surgery and 23 biopsy; 51 received radiotherapy (RT) with (n = 37) or without (n = 14) chemotherapy. Median RT dose was 40 Gy (range 12-55 Gy).
Ten (12%) patients progressed locally and 43 (55%) had a systemic relapse. Central nervous system (CNS) was the site of relapse in 12 (14%) cases. The 5-yr overall survival, lymphoma-specific survival, disease-free survival and local control rates were 53%, 59%, 41% and 87% respectively. In the univariate analyses, favorable prognostic factors were early stage, conservative surgery, RT administration and combined modality treatment. Multivariate analysis showed that early stage and the use of RT were favorable prognostic factors.
The outcome of PBL is fair. Local control is excellent with RT or combined modality treatment but systemic relapses, including that in the CNS, occurs frequently.

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Available from: Marco Krengli, Oct 06, 2015
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    • "Primary breast lymphoma (PBL) is a rare but distinct extranodal lymphoma subtype, comprising 0.5% of breast malignancies, around 1% of all non-Hodgkin lymphoma (NHL) and <3% of extranodal lymphomas [1] [2] [3] [4] [5] [6]. Over 98% of cases occur in women [2] [3] [4] [5] [6] [7] [8] [9] [10]; the most common histology is diffuse large B-cell lymphoma (DLBCL). The case definition proposed by Wiseman and Liao, modified by Hugh et al. requires the presence breast tissue in close proximity with lymphoma, no antecedent diagnosis of lymphoma and no extramammary disease other than ipsilateral axillary nodes [11] [12]. "
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    ABSTRACT: Primary breast lymphoma is a rare form of extranodal lymphoma, defined by the presence of a primary lesion within the breast with or without regional nodal involvement but no other extra-mammary sites of involvement. It comprises diverse histologic subtypes, but diffuse large B-cell lymphoma is the most common. In this review, we describe in detail the clinical features, diagnosis and staging, pathogenesis, risk factors and therapy of primary breast diffuse large B-cell lymphoma. We consider choice and number of cycles of chemotherapy, the indications for radiotherapy and discuss the need for central nervous system prophylaxis. We also provide a brief overview of the less commonly encountered histologic subtypes including marginal zone, follicular, Burkitt and breast implant associated anaplastic large cell lymphoma. We conclude with a suggested treatment approach and potential areas of future research.
    Cancer Treatment Reviews 09/2014; 40(8). DOI:10.1016/j.ctrv.2014.05.010 · 7.59 Impact Factor
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    • "According to the definition of Wiseman and Liao [1], primary breast lymphoma (PBL) is diagnosed when the first major manifestation site of lymphoma is the breast without involvement of any other organ. Due to this relatively narrow definition, PBL represents less than 1% of all non-Hodgkin's lymphomas (NHL) and 1.7% to 3% of all extranodal NHLs [2]. The most common histologic type of PBL is diffuse large B cell lymphoma (DLBL), while follicular lymphoma (FL) is less common. "
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    ABSTRACT: Primary breast lymphoma (PBL) is a rare disease, particularly in males. Diffuse large B cell lymphoma is the most common PBL, while follicular lymphoma is less common. Furthermore, primary follicular lymphoma of a male breast is rarely reported. We report a male patient with primary follicular lymphoma of the breast and hepatocellular carcinoma (HCC). A 46-year-old man was diagnosed with liver cirrhosis secondary to chronic hepatitis B infection. Ten years later, he underwent segmentectomy of the liver due to HCC. Another 5 months later, he presented with a painless mass in the right chest wall. The mass was diagnosed as follicular lymphoma of the breast. The stage was IEA and he did not receive adjuvant therapy. Although only a few cases have been reported, lymphoma should be considered as a possible cause of breast mass, even in male patients.
    Cancer Research and Treatment 01/2014; 46(1):104-7. DOI:10.4143/crt.2014.46.1.104 · 3.32 Impact Factor
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    • "With appropriate management, a high rate of locoregional control can be achieved for primary breast lymphoma, although there is often systemic relapse. The 5-year overall survival for diffuse large B-cell lymphoma in the breast has been reported to range from 60% to 65% [30-32]. Of the 10 cases included in our study, two patients underwent excision with chemotherapy, three received radiation therapy with chemotherapy, and the remaining five received only chemotherapy (Table 1). "
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    ABSTRACT: Hematological malignancies rarely affect the breast, and the majority of those that do are lymphomas. In this review, we describe the clinical aspects and multimodal imaging findings of breast lymphoma. We also illustrate the key clinical and radiological findings that allow it to be distinguished from various other malignant and benign diseases of the breast. Breast lymphoma manifests as a breast mass, a change in the subcutaneous tissue or the skin, or enlargement of the associated lymph node on radiological examination. Radiological findings associated with other breast malignancies, such as calcifications, spiculations, or architectural distortions are extremely rare. Skin and subcutaneous changes frequently accompany T-cell lymphoma. Multimodal breast imaging characteristics may aid in the diagnosis of breast lymphoma.
    Journal of Breast Cancer 09/2013; 16(3):254-265. DOI:10.4048/jbc.2013.16.3.254 · 1.58 Impact Factor
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