Secondary Breast Lymphoma Research Articles

Secondary Breast Lymphoma: A Case Report and Review of Literature

Secondary Breast Lymphoma: A Case Report and Review of Literature

Reports of primary and secondary breast lymphoma: our experience in King Chulalongkorn Memorial Hospital

We report four cases of primary breast lymphoma (PBL) and five cases of secondary breast lymphoma (SBL). We illustrate imaging findings in various imaging modalities including mammography, ultrasonography (US), magnetic resonance imaging (MRI) and positron emission tomography (PET) as well as review literature concerning this uncommon condition.

Unexpected Rare Association of Secondary Breast, Thyroid, and Ovarian Lymphomas in a Female Patient with Burkitt Lymphoma: PET-CT Findings.

We report the case of a 15-year-old female, followed for Burkitt lymphoma with initial ovarian presentation. Positron emission tomography-computed tomography (PET-CT) with 18 F-fluorodeoxyglucose ( 18 F-FDG) performed to evaluate initial extension assessment showed an unexpected association with secondary breast, thyroid, and ovarian lymphomas. To our knowledge, this association is very rare, unusual, and these extranodal presentations have been reported in literature as a separate case report. Authors highlight performance of PET-CT with 18 F-FDG to determinate the secondary origin of this multiglandular involvement, to establish a lesional map of the whole body, and to contribute to the therapeutic decision.

A Rare Case of Bilateral Primary B-Cell Non-Hodgkin Lymphoma of Breast

Primary B-Cell Non-Hodgkin Lymphoma of Breast is a rare presentation of breast malignancy and it is necessary to differentiate it from secondary breast lymphoma as prognosis and treatment varies based on the diagnosis. We report a case of 47-year-old female with bilateral PBNHL of Breast which is rare due to younger age of presentation than earlier reported cases of this malignancy, lump with “peau de orange” appearance seen in both the breasts which is usually seen with high grade lymphoma and complete recovery of the patient while bilateral PBL outlines poor prognosis. Mammosonography findings included dilated ducts with hypoechoiec areas. MRI showed altered signal intensity. Findings of the imaging studies are non-specific and vary widely from case to case which is why biopsy which is gold standard was done to confirm the diagnosis

CLINICAL, IMAGING AND PATHOLOGICAL ASPECTS OF MAMMARY LYMPHOMAS SECONDARY TO MALIGNANT T- CELL CUTANEOUS LYMPHOMAS

Primary cutaneous lymphomas rank as the second most common clinical form of extranodal non-Hogdkin malignant lymphomas. Among non-Hodgkin malignant skin T-cell lymphomas, Mycosis Fungoides (MF) is the most frequent clinical occurence. The MF lymphoma originates in skin-homing helper T-cells, which express the CD4 + marker, showing chronic evolution, with recurrent lesions. In advanced stages, patients with Mycosis Fungoides may experience severe/extensive skin lesions or extracutaneous localizations of the disease. The secondary breast lymphoma is more common in non-Hodgkin malignant lymphoma than in Hodgkin lymphoma. Among the mammographic characteristics of breast lymphoma we mention: oval or round tumor mass, with well-defined or indistinct margins, absence of intratumoral calcifications, presence of intramammary lymph nodes, supra-adjacent skin thickening and lymphedema that causes diffuse increase in breast density. The ultrasound features of breast lymphoma run as follows: it is oval or round in shape, with well-defined or indistinct margins, which in Doppler ultrasound are identified as hypervascularized masses. The description of the imaging features of mammary lymphomas secondary to cutaneous T-cell lymphomas is required before performing the breast core-needle biopsy.

Lymphoma of the breast: A clinicopathologic analysis of 51 cases with a specific emphasis on patients with a history of breast carcinoma.

We herein report our experience with 51 breast lymphoma (BL) cases from 46 patients with a specific focus on patients with a history of breast carcinoma. The overall most common subtype was diffuse large B-cell lymphoma, followed by MALT lymphoma and follicular lymphoma. Eleven of 46 (24%) patients had either previous history of or concurrent breast carcinoma. There was no significant difference in clinicopathologic characteristics between patients with primary and secondary BL. On follow-up, patients with secondary BL had a worse disease-free survival with no difference in overall survival between the two groups.

Clinicopathological Features of Hematological Malignancies Presenting As Breast Lesions on Mammography: The Mount Sinai Medical Center Experience

Background:Breast involvement by hematological malignancies is extremely rare and encompasses approximately 1% of all breast tumors. In this retrospective data review, we aimed to evaluate the clinical, pathological and radiographic characteristics of hematological malignancies involving the breast.Methods:Our database was searched for "leukemia", "lymphoma" and "myeloma" in reports of breast biopsies, obtained between August 2009 and August 2019. A total of 13 cases met inclusion criteria.Results:A total of 13 breast biopsies with the diagnosis of leukemia or lymphoma were identified. All samples were obtained through ultrasound guided core needle biopsy. All 13 patients were females, 61.54% Caucasian, 15.38% Black, 15.38% Hispanic and 7.7% Asian, with median age of 71 years. In 8/13 patients (61.54%), a palpable breast lesion prompted the imaging study, while the remaining 5/13 patients (38.46%) were detected on routine screening mammography. Average lesion size was 2.7cm (±2.47cm, SD). On mammogram, 61.5% of cases were described as BIRADS 4, 30.8% as BIRADS 0 and 7.7% as BIRADS 5. Pathological evaluation revealed all cases (100%) were lymphomas. The commonest lymphoma subtype was marginal zone B-cell Lymphoma (MZL) (38.48%), followed by diffuse large B cell lymphoma (DLBCL) (15.38%) and small lymphocytic lymphoma (SLL) (15.38%). Burkitt's lymphoma (7.69%), follicular lymphoma (7.69%), hairy cell leukemia (7.69%) and lymphoplasmacytic lymphoma (7.69) were also identified. Primary breast lymphoma (PBL) was identified in 4/13 patients (30.77%), while in 9/13 (69.23%) the breast lesion were secondary breast lymphomas (SBL). Treatment options for patients with PBL consisted of local radiation in two patients, R-CHOP chemotherapy in one patient and immunotherapy with rituximab plus radiation in one patient. Patients with SBL received systemic chemotherapy. None of the patients were treated surgically.Conclusion:Hematological malignancies involving the breast can present as a palpable or subclinical lesions with a high BIRADS on mammography. MZL was the predominant subtype, followed by DLBCL and SLL. PBL can be a localized disease suitable for conservative management. Disclosures No relevant conflicts of interest to declare.

Comparison of Clinical Features Between Primary and Secondary Breast Diffuse Large B Cell Lymphoma: A Yokohama Cooperative Study Group for Hematology Multicenter Retrospective Study.

We performed a retrospective analysis of DLBCL with breast involvement to compare the prognosis of primary breast lymphoma (PBL) to secondary breast lymphoma (SBL; especially in limited stage cases). We retrospectively reviewed records of 25 diffuse large B-cell lymphoma (DLBCL) patients with breast involvement who received chemotherapy between January 2000 and August 2012. We compared clinical features and prognosis among patients with PBL (n = 11), limited stage SBL (LSBL; n = 6), and advanced stage SBL (ASBL, n = 8). The PBL group had significantly lesser patients with breast tumours (BTs) > 5cm than the SBL group (P = 0.02). After a median follow-up of 71.3months, we observed significantly better 5-year overall survival (OS) in the PBL group (90.0%) than in the LSBL (33.3%, P = 0.01) group, but not for progression-free survival (PFS). Patients with BT > 5cm had worse OS (P = 0.01) and PFS (P = 0.04) than those with BT ≤ 5cm. PBL had a better prognosis than SBL among limited stage DLBCL.

Imaging Characteristics of Breast Lymphoma; a Case Series.

Breast involvement by lymphoma is rare. It can occur as a primary breast tumour or as an extranodal manifestation of the systemic disease. The imaging features of breast lymphoma (BL) are not characteristic. Biopsy is necessary for diagnosis due to non-specific imaging features. A retrospective electronic medical chart review was conducted of patients diagnosed with lymphoma of breast that underwent diagnostic radiological procedures (including mammography, ultrasound breast, computed tomography (CT) scan and positron emission tomography (PET/CT) scan from 1 July 2018 to 31 March 2019 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Pakistan. Four patients were identified. On mammogram, the most common finding consisted of the presence of high-density masses with circumscribed or indistinct margins. On ultrasound, hypoechoic masses and indistinct diffuse infiltrative patterns were observed. PET/CT and CT were helpful in detecting extramammary sites of disease and for classifying the disease into primary or secondary BL. The early diagnosis of the BL is important. The radiologists should include lymphoma in the differential diagnosis when there is the absence of microcalcifications or spiculated margins on mammography and ultrasound.

Primary and Secondary Breast Lymphoma: Focus on Epidemiology and Imaging Features.

Aim of this study was to select all the cases of Primary (PBL) and Secondary (SBL) Breast Lymphoma from our breast unit since 01/01/2000, to obtain up-to-date data on the prevalence of this rare pathology and to analyze imaging features, with a special focus on CT. All pathological reports of breast biopsies performed from 01/01/2000 to 01/01/2019 were at first screened. Among them, we performed two different researches, looking for key words suggesting either a diagnosis of lymphoma or any other malignant disease. Using the Wiseman criteria, we identify PBL and SBL. All imaging features of PBL and SBL were analyzed. Prevalence of lymphoma amongst suspicious breast masses and amongst all breast malignancies were calculated. Out of 42,505 histopathology reports from mammary nodule biopsies, we found 19,354 malignancies. We were able to identify 11 patients affected by PBL (0,03% of suspicious breast lesions, 0.06% of breast malignancies), and 23 cases of SBL (0,05% of suspicious breast lesions, 0,12% of breast malignancies). Most common isotype in PBL was DLBC lymphoma, whereas in SBL that resulted Follicular lymphoma. In PBL group, we were able to retrieve images7 CT or CT-PET study performed at diagnosis 7 US, 1 mammography and and 1 MR. In SBL group, we analyzed 14 CT/CT-PET examinations, 11 US studies and 3 mammography. PBL and SBL are rarer than considered until now. There is no definite imaging characteristic able to distinguish between these two pathologies and among them and breast cancer.

Primary and Secondary Breast Lymphoma: Clinical, Pathologic, and Multimodality Imaging Review.

Breast lymphoma is a rare hematologic neoplasm that originates in the breast lymphoid tissue and includes primary breast lymphoma (PBL) and secondary breast lymphoma (SBL). PBL involves the breast lymphoid tissue in the absence of previously identified extramammary lymphoma and widespread disease. SBL is the most common metastasis to the breast, accounting for 17% of metastatic disease to the breast. PBL and SBL usually demonstrate imaging phenotypes that overlap with those of primary breast carcinoma, which makes a prospective diagnosis of breast lymphoma challenging. These nonspecific imaging features include an iso- to hyperdense oval mass or masses at mammography, a hypoechoic or mixed-echogenicity hypervascular mass at US, an enhancing mass with type II kinetics at MRI, and high fluorine 18-fluorodeoxyglucose avidity at PET. In cases of suspected lymphoma, reviewing the clinical history, using appropriate biopsy techniques, and evaluating for multiplicity, bilaterality, and distant disease are critical for diagnosis and management. A patient with PBL generally has an earlier clinical presentation with a palpable abnormality and a solitary imaging finding. In contrast, multiple masses in an older patient and an occult clinical presentation favor an SBL diagnosis. ©RSNA, 2019.

Breast lymphoma occurring after an invasive ductal breast carcinoma developed in the same area: A case report and literature review

Chemo- and radiotherapy are treatments very helpful to cure cancers but are also well known for adverse effects such as secondary cancers. Breast cancers following Hodgkin lymphoma have been relatively well studied. Breast cancers after radiotherapy covering or nearby breasts or nipples are usually carcinomas or secondary sarcomas. Among the big cohort of patients treated for breast carcinomas, breast lymphomas developed in the same area are not usual. Nevertheless, published studies described a significant increased risk of non-Hodgkin lymphoma after initial radiotherapy for a solid cancer. Here, we report a case of a secondary breast lymphoma observed in a 53-year-old woman treated 13 years before for a ductal carcinoma and analyse such second tumors with a review of the literature. This case report emphasizes the importance of the biopsy in case of recurrence in breast cancer to give the appropriate treatment.

Hematolymphoid lesions of the breast.

Hematolymphoid malignancies of the breast are most commonly neoplasms of mature B-lymphocytes, and may arise as a primary disease or by secondary involvement of a systemic disease. Primary breast lymphomas (PBL) account for 0.04-0.5% of breast malignancies, less than 1% of all non-Hodgkin's lymphomas (NHL), and less than 5% of extranodal lymphomas (Lakhani et al., 2012; Swerdlow et al., 2008; Joks et al., 2011; Barişta et al., 2000; Giardini et al., 1992; Brogi and Harris, 1999; Topalovski et al., 1999).1-7 Secondary breast lymphomas (SBL) are also rare, with an estimated annual incidence of 0.07% (Domchek et al., 2002; Talwalkar et al., 2008).8,9 Recognition of breast lesions as hematolymphoid is critical to distinguish them from other entities that can occur in the breast.

Intrathecal Prophylaxis Might Be Required For Primary and Secondary Breast Lymphoma to prevent Central Nervous System Relapse

BackgroundBreast lymphomas is a rare type of malignant lymphoma. The major histopathological type of breast lymphoma is diffuse large B-cell lymphomas (DLBCL). Although conventional treatment regimen is cyclophosphamide, doxorubicin, vincristine, and predonisolone with rituximab (R-CHOP), the optimal cycles of chemotherapy, role of additional radiotherapy, and efficacy of intrathecal (IT) prophylaxis are still unclear. MethodWe retrospectively analyzed the clinical features and treatment outcomes of 22 patients with newly diagnosed primary breast lymphoma (PBL) of stage IE and IIE and secondary breast lymphoma of stage IIIE and IVE, and evaluated details of 20 DLBCL patients. All patients were treated at our institution between May 2002 and July 2013. Patients of stage IE were treated by 8 cycles of rituximab plus three cycles of CHOP-21 with radiotherapy, and patients of stage IIE-IVE were treated by 8 cycles of rituximab plus 6-8 cycles of CHOP-21 with or without radiotherapy. All patients were considered to receive intrathecal prophylaxis unless clinical study setting or patients' denial. Patients were divided into three groups; primary breast lymphoma (PBL) of stage IE, PBL of stage IIE, and secondary breast lymphoma of stage IIIE and IVE. ResultThere were 22 malignant lymphoma patients of breast such as one follicular lymphoma patient, one Burkitt lymphoma patient, and 20 DLBCL patients with no bilateral breast involvement. In patients with DLBCL of the breast, the median age was 60 years (range 32–69 years), with all female. The median largest tumor diameter was 5 cm, and eight patients had bulky disease (>5 cm). Nine of 20 patients (45%) received at least once of IT prophylaxis during one to two cycles of R-CHOP therapy. Six patients were stage IE, nine patients were stage IIE, and five patients were stage III and IVE, who had another invasion including liver, bone, and bone marrow. CR rate after initial therapy was 90% (18/20). Five of 20 patients (25%) developed central nervous system (CNS) relapse with the median time to CNS relapse of 28 months. Although four of 11 (36.4%) patients without IT prophylaxis versus one of nine (11.1%) patients with IT prophylaxis developed CNS relapse with no significant difference between two groups (p=0.363), and IT prophylaxis tends to prevent CNS relapse. The median follow-up time was 48.5 months, and the 3-year progression free survival (PFS) and overall survival (OS) in each group were 75%, 87.5%, and 40.0% (p=0.154), and 100%, 85.7%, and 53.3% (p=0.244), respectively. ConclusionsPrimary and secondary breast lymphoma is still considered high-risk for CNS relapse in Rituximab era. IT prophylaxis might prevent CNS relapse in breast lymphoma patients, and, further study is needed to evaluate the efficacy of IT prophylaxis or another appropriate approach for CNS relapse. Disclosures:Nishimura:Chugai Pharmaceutical CO., LTD.: Consultancy. Yokoyama:Chugai Pharmaceutical CO., LTD.: Consultancy.

The features of breast lymphoma on MRI

To investigate the morphological features of breast lymphoma (BL) on MRI. MRI features of 20 patients with BL (12 primary and 8 secondary) were reviewed according to Breast Imaging-Reporting and Data System categories. 19 cases were unilateral and 1 was bilateral. According to the enhanced images, of the 20 cases, BL presented as a mass in 11 (55%), as an enhancement with no mass effect in 7 (35%) and as a mass and mixed enhancement with no mass effect in 2 (10%). There were 38 masses and 44 lesions with no mass effect in our study. All lesions showed mild heterogeneous internal enhancement. For lesions with mass effect, the margins were smooth in 32% (12/38) and irregular in 68% (26/38); and the shape was oval in 87% (32/38). Kinetic curve assessment (13 cases, 38 lesions) revealed that the average initial rise rate was 104%. The type II enhancement curve appeared in 55% (21/38) of lesions. No significant differences between the primary and secondary BL were observed for any of the MRI features. BL mostly appeared oval with irregular margins showing mild heterogeneous internal enhancement and/or as enhanced lesions with no mass effect with mild heterogeneous internal enhancement. Some special features on MRI are useful for the diagnosis of BL.

Comparison between incidental malignant and benign breast lesions detected by computed tomography: A systematic review

With increasing use of CT for a variety of diagnostic pathways, breast incidentalomas will be identified more frequently. Therefore, it is important for radiologists to know typical CT appearances of malignant and benign breast lesions. The aim of this study was to compare radiological features of benign and malignant incidental breast findings on CT reported in the literature. A search for appropriate studies published between 1988 and 2012 yielded five results with a total of 214 patients/257 lesions. Morphological features of the described breast masses, such as shape, margins, enhancement, axillary lymphadenopathy and calcifications, were analysed. The prevalence of incidental breast carcinoma varied from 9.2% to 60.9% of the lesions. The frequency of benign lesions was 30.4-71.8%. The remaining incidental findings were intramammary metastases and primary or secondary breast lymphomas. Malignant lesions were larger in size, were round in shape and demonstrated a higher density compared with benign lesions. There was no significant difference in the margin characteristics of the masses between the groups. The morphological features previously postulated as typical for malignancy turned out to be non-specific. Benign and malign breast incidentalomas are not safely distinguished from each other on standard chest CT. Therefore, all breast incidentalomas should be evaluated by further radiological/histological investigations.

Non-Hodgkin’s Lymphoma of the Breast: Report of Five Cases and Review of the Literature

SUMMARY Non-Hodgkin's lymphoma (NHL) of the breast can be either primary or secondary. Both are rare diseases accounting less than 0.6% of all breast malignancies. In this study we report our experience with five cases of breast lymphoma, 3 of them being primary and 2 of them being secondary breast lymphoma, retrospectively. All patients were female with a median age of 47 years and presen- ted with breast masses (3 in the right breast and 2 in the left). The histologic subtype showed broad spectrum, one patient had pe- ripheral T-cell lymphoma and 4 patients had B-cell lymphomas; 2 were diffuse large B-cell lymphomas, 1 was a diffuse small B-cell lymphoma, and the last patient was a marginal zone lymphoma. Partial mastectomy was performed in 2 patients to carry out diag- nosis. Anthracycline-based chemotherapy regimens were employed in 4 patients. Radiotherapy was added to other treatment mo- dalities in 3 cases. At a median follow-up of 5 years, all patients were alive other than one who had been diagnosed with periphe- ral T-cell lymphoma just after pregnancy and showed resistance to the applied treatment. The treatment and the prognosis of bre- ast lymphomas were not different from the currently indicated for nodal NHL with the same stage and histological subtype.

Primary and secondary breast lymphoma: prevalence, clinical signs and radiological features

The purpose of this study was to determine the prevalence, clinical signs and radiological features of breast lymphoma. This is a retrospective review of 36 patients with breast lymphoma (22 primary and 14 secondary). 35 patients were female and 1 was male; their median age was 65 years (range 24-88 years). In all patients, the diagnosis was confirmed histopathologically. The prevalence of breast lymphoma was 1.6% of all identified cases with non-Hodgkin lymphoma and 0.5% of cases with breast cancer. B-cell lymphoma was found in 94% and T-cell lymphoma in 6%. 96 lesions were identified (2.7 per patient). The mean size was 15.8 ± 8.3 mm. The number of intramammary lesions was higher in secondary than in primary lymphoma. The size of the identified intramammary lesions was larger in primary than in secondary lymphoma. Clinically, 86% of the patients presented with solitary or multiple breast lumps. In 14%, breast involvement was diagnosed incidentally during staging examinations. On mammography, intramammary masses were the most commonly seen (27 patients, 82%). Architectural distortion occurred in three patients (9%). In three patients (9%), no abnormalities were found on mammography. On ultrasound, the identified lesions were homogeneously hypoechoic or heterogeneously mixed hypo- to hyperechoic. On MRI, the morphology of the lesions was variable. After intravenous administration of contrast medium, a marked inhomogeneous contrast enhancement was seen in most cases. On CT, most lesions presented as circumscribed round or oval masses with moderate or high enhancement.

MR imaging features of secondary breast lymphoma in a male patient: a case report and literature review

We reported the rare case of an elderly man with secondary breast lymphoma (SBL) associated with magnetic resonance imaging findings. MR images demonstrated multiple well-defined masses in the left breast, with heterogeneous enhancement on dynamic contrast-enhanced sequences. The time signal-intensity curve rapidly increased during the initial rise phase and washed out during the delayed phase. The apparent diffusion coefficient (ADC) value was 0.649 × 10−3 mm2/s. Maximum intensity projection (MIP) showed that the masses were distributed in the upper outer quadrant, in the axillary region and in the lower outer region of the left chest wall. The pathology confirmed the diagnosis of non-Hodgkin’s lymphoma. The combination of morphological and kinetic features, as well as a significantly lower ADC value, are helpful in the diagnosis of breast lymphoma and its differentiation from breast cancer.

Clinical Features and Treatment Outcomes of Non-Hodgkin's Lymphoma with Breast Involvement; Multi-Institutional Analysis of 98 Patients in Korea.

Abstract 5024 IntroductionThe non-Hodgkin's lymphoma (NHL) with breast involvement is an extremely rare extranodal presentation. The aim of this study is to analyze the clinical features and treatment outcomes of NHL with breast involvement, and to investigate whether the arbitrary classification between primary breast lymphoma (PBL) and secondary breast lymphoma (SBL) has any clinical relevance. Patients and MethodsWe retrospectively analyzed 98 patients newly diagnosed as NHL with breast involvement from 16 hospitals in Korea between January 1994 and June 2009. The eligibility criteria included: (1) histological confirmation by pathologist should be made, (2) documentation of one or both breasts involvement by histology or imaging modalities was needed. The PBL was defined as disease localized to one or both breasts ± regional lymph nodes (ipsilateral axillary, supraclavicular and internal mammary lymph nodes), and SBL defined as disease with systemic lymph nodes and/or other extranodal organ involvement as well as one or both breasts involvement. Mediastinal and cervical lymph nodes were not regarded as regional lymph nodes. Recurrent lymphomas in the breast following prior treatment were not included in this analysis. ResultsThe median age at diagnosis was 45 (range, 17-83) years, and median follow-up duration was 39.2 (range, 0.5-186.0) months. The two most common histologic subtypes included were diffuse large B-cell (68 patients, 69.4%) and mucosa-associated lymphoid tissue (8 patients, 8.2%) histology. Other 7 histologic subtypes were identified. Among 98 patients, 89 (91%) were treated at least 1 cycles of systemic chemotherapy, 82 (84%) treated with anthracycline-based regimens, 44 (44.9%) treated with combination of chemotherapy and rituximab. Any surgery or any radiotherapy to the breasts was performed in 27 (27.6%) patients, respectively. According to the definition, PBL and SBL group were 58 (59.2%) and 40 (41.8%) patients, respectively. The estimated 5-year progression-free survival (PFS) and overall survival (OS) was 51.2% ± 6.8 and 61.3% ± 6.0, respectively. Overall response rate (ORR) of 93 patients who were evaluable was 91.4% (CR, 76.3%; PR, 15.1%). Compared the baseline characteristics of PBL with those of SBL, PBL group showed more favorable clinical factors as 0 or 1 of Eastern Cooperative Oncology Group performance status (p<0.001), normal LDH level (p=0.003), absence of B symptom (p=0.001) and low or low-intermediate international prognostic index (p<0.001). 14 (24%) of PBL group were treated with abbreviated course (£4 cycles) of systemic chemotherapy and local therapy, 11 (28%) of SBL group were treated 4 or less than 4 cycles of systemic chemotherapy because of mainly disease progression or early death. ORR was significantly higher in PBL group (96.6% vs 72.5%, p=0.005), and estimated 5-year PFS (63.6% ± 8.7 vs 35.2% ± 8.9, p<0.001) and OS (71.8% ± 7.2 vs 45.3% ± 9.9, p=0.004) was also significantly longer in PBL group compared with SBL group. Eight (8.2%) patients had central nervous system (CNS) relapse or progression in the course of disease, and PBL group had a significantly higher rates of CNS relapse or progression compared with SBL group (6 [10.3%] vs 2 [5%], p=0.046). In multivariate analysis for PFS, 4 or less than 4 cycles of systemic chemotherapy regardless of any local treatments (hazard ratio [HR], 5.14; 95% confidence interval [CI], 2.18-12.12) and more than 2 of extranodal organ involvement (HR, 10.64; 95% CI, 4.75-23.83) were independent prognostic factors for shorter PFS. And, for OS, 4 or less than 4 cycles of systemic chemotherapy regardless of any local treatments (HR, 4.03; 95% CI, 1.90-8.54) was the only independent prognostic factor for shorter OS. ConclusionAlthough criteria for PBL and SBL, we traditionally used, did not consider tumor biology and an arbitrary definition, we confirmed that the patients with NHL involved breasts could be classified into two different groups; traditional PBL and SBL according to the clinical characteristics, treatment outcomes and patterns of failure in this analysis. Continuation (>4 cycles) of active systemic chemotherapy was the only prognostic factor for OS, regardless of any local treatment. Thus, standard systemic chemotherapy should be the mainstay of treatment for NHL involved breasts. And, newer treatment strategy adapted on the poor prognosis should also be warranted. DisclosuresNo relevant conflicts of interest to declare.