Primary breast lymphoma: a prognostic analysis and literature review

Abstract

Objective To summarize the clinical characteristics and evaluate the feasible treatments of primary breast lymphoma (PBL). Methods The clinical data of 34 PBL patients (age 24-79 years) who were treated in our hospital between April 2006 and December 2013 were reviewed. Of these 34 patients, 18 had stage ⅠE PBL and 16 had stage ⅡE PBL. Pathological types included diffuse large B cell lymphoma (29 patients), anaplastic large cell lymphoma (2 patients), marginal zone lymphoma (2 patients), and mantle cell lymphoma (1 patient). Two patients underwent surgery, four patients received chemotherapy alone, five patients received chemoradiotherapy, fourteen patients underwent surgery plus chemotherapy, and nine patients underwent surgery plus chemoradiotherapy. The 5-year overall survival (OS) and progression-free survival (PFS) rates were determined by the Kaplan-Meier estimator. Results During follow-up, 26 patients were alive without lymphoma and 8 patients had died by the end of follow-up (7 died from lymphoma and 1 died from chemotherapy-related hepatic failure). Among the 6 patients who relapsed, 5(83.3%) had recurrence within the first 2 years of treatment. In particular, 1 patient who had bilateral breast involvement developed left breast relapse after bilateral mastectomy and chemotherapy, 2 patients had bone marrow metastasis, 1 patient had lung and mediastinal lymph node metastases, and 2 had skin relapse. The 5-year OS and PFS rates of all patients were 75% and 75%, respectively. Conclusions Since PBL is a rare malignancy, its overall prognosis is fair and the incidence of local relapse is low with chemotherapy alone or in combination with other treatments. However, further studies on the development of more effective treatments will be required for patients who have failed the existing treatments. Key words: Primary breast lymphoma/combined treatment; Diffuse large B cell lymphoma/combined treatment; Prognosis