Abstract
BackgroundPrimary breast lymphoma is a rare condition, and distinguishing it from breast cancer is important because their treatments differ radically. Moreover, a recent report showed that mastectomy offered no benefit in the treatment of primary breast lymphoma.Case presentationA 59-year-old woman was treated with adjuvant chemotherapy and local radiation after surgery for left breast cancer. She presented with a rapidly growing mass in the right breast at 20 months after surgery. Mammography and computed tomography revealed a massive tumour. She was diagnosed with primary breast lymphoma by aspiration cytology, and surgery was performed. Histopathological and immunohistochemical findings confirmed a diffuse large B-cell type primary breast lymphoma.ConclusionIn this case, the lymphoma exhibited rapid growth despite chemotherapy for a malignancy in the contralateral breast. The patient had developed bronchiolitis obliterans organizing pneumonia due to radiation. Therefore, surgical treatment of the lymphoma was selected.
Highlights
Primary breast lymphoma is a rare condition, and distinguishing it from breast cancer is important because their treatments differ radically
Primary breast lymphoma (PBL) is a rare condition, and it represents less than 0.7% of all malignant breast tumours
It affects less than 1% of patients with non-Hodgkin lymphoma (NHL) and constitutes only 2% of all extranodal NHLs [1,2,3,4,5,6,7,8,9]
Summary
It is difficult to select the treatment modality for PBL, but we considered surgical therapy to be better in this very special case. There are various treatment options for PBL: surgery, radiation, and chemotherapy have been used alone or as combination therapy. A recent paper showed that treatment by mastectomy offered no survival benefit or protection from recurrence [11]. It reported that treatment including radiation therapy in node-negative patients and treatment including chemotherapy in node-positive patients exhibited benefit with regard to both survival and recurrence rates. The most common site of relapse is reportedly the central nervous system [8,9,10] This patient showed an unusual clinical course: PBL was discovered 20 months after surgery for a malignancy in Competing interests.
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