Breast Cancer Research and Treatment

, Volume 169, Issue 1, pp 197–202 | Cite as

Management and outcomes of women diagnosed with primary breast lymphoma: a multi-institution experience

  • Nafisha Lalani
  • Karen M. Winkfield
  • Daniel E. Soto
  • Beow Y. Yeap
  • Andrea K. Ng
  • Peter M. Mauch
  • Rachel B. Jimenez
Brief Report

Abstract

Purpose

Primary breast lymphoma (PBL) comprises < 1% of breast malignancies, leading to a paucity of data to guide management. We evaluated PBL recurrence patterns across two academic hospitals in the era of modern systemic-therapy and radiotherapy.

Methods

Patients diagnosed with PBL between October 1994 and June 2016 were identified. Demographic/clinical variables were assessed via primary chart review. Local control (LC) was estimated using the cumulative incidence function and overall survival (OS) using the Kaplan–Meier method.

Results

Thirty-five patients were identified. Median follow-up 5.8 years (range 0.3–17.8 years). Median age at diagnosis 66 years (range 35–86 years). Indolent versus aggressive lymphoma represented 57% (n = 20) and 43% (n = 15) of the cohort, respectively. All patients with aggressive lymphoma received systemic therapy. Thirty patients (86%) received radiotherapy (RT). Breast-only RT was used in 57% (n = 20); 23% (n = 7) received regional nodal irradiation (RNI), and 6% (n = 2) received limited-field RT. Local recurrences were observed in 3% (n = 1), contralateral breast 9% (n = 3), CNS 6% (n = 2), distant non-CNS 30% (n = 10), both local and distant 3% (n = 1). There were no regional nodal recurrences. The 6-year LC rate was 95% for indolent and 81% for aggressive subtypes. The 6-year OS rate was 87% for indolent and 70% for aggressive subtypes.

Conclusions

The majority of patients in this PBL cohort received breast-only RT with no nodal relapses, suggesting that prophylactic RNI may be unnecessary. Given the prevalence of contralateral breast involvement at diagnosis and at recurrence, vigilant surveillance of bilateral breasts may be warranted. The role of CNS prophylaxis requires further investigation.

Keywords

Breast cancer Primary breast lymphoma Rare malignancies 

Notes

Acknowledgements

The authors would like to thank the patients that contributed data to this study.

Compliance with ethical standards

Conflicts of interest

The authors declare that they do not have any conflicts of interest to disclose.

References

  1. 1.
    Strobbe L, Peterse H, Van Tinteren H et al (1998) Angiosarcoma of the breast after conservation therapy for invasive cancer, the incidence and outcome. An unforseen sequela. Breast Cancer Res Treat 47(2):101CrossRefPubMedGoogle Scholar
  2. 2.
    Wiseman C, Liao K (1972) Primary lymphoma of the breast. Cancer 29:1705–1712CrossRefPubMedGoogle Scholar
  3. 3.
    Jennings W (2007) Primary Breast lymphoma: the role of mastectomy and the importance of lymph node status. Ann Surg 245:784–789CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Yahalom J, Illidge T, Specht L (2015) Modern radiation therapy for extranodal lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys 92(1):11–31CrossRefPubMedGoogle Scholar
  5. 5.
    Ryan G, Roos D, Seymour J (2006) Primary non-Hodgkin’s lymphoma of the breast: retrospective analysis of prognosis and patterns of failure in two Australian centers. Clin Lymphoma Myeloma 6(4):337–341CrossRefPubMedGoogle Scholar
  6. 6.
    Ryan G, Martinelli G, Kuper-Hommel M et al (2008) Primary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group. Ann Oncol 19(2):233–241CrossRefPubMedGoogle Scholar
  7. 7.
    Topalovski M, Crisan D, Mattson J (1999) Lymphoma of the breast. A clinicopathologic study of primary and secondary cases. Arch Pathol Lab Med 123(12):1208PubMedGoogle Scholar
  8. 8.
    Schouten J, Weese J, Carbone P (1981) Lymphoma of the breast. Ann Surg 194(6):749CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Wong W, Schild S, Halyard M (2002) Primary non-Hodgkin lymphoma of the Breast: The Mayo Clinic Experience. J Surg Oncol 80:19–25CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Harvard UniversityBostonUSA
  2. 2.Department of Radiation OncologyPrincess Margaret Cancer Centre, University of TorontoTorontoCanada
  3. 3.Department of Radiation OncologyWake Forest Baptist Comprehensive Cancer CenterWinston-SalemUSA
  4. 4.Department of Radiation OncologyMassachusetts General HospitalBostonUSA
  5. 5.Division of Hematology/Oncology, Department of MedicineMassachusetts General HospitalBostonUSA
  6. 6.Department of Radiation OncologyBrigham and Women’s HospitalBostonUSA

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