[Primary breast lymphoma--a report of 27 cases with literature review].
OBJECTIVE
Primary breast lymphoma (PBL) is an uncommon disease with poor clinical outcome. This study was to investigate clinicopathologic features and optimal treatment of PBL.


METHODS
Clinical records of 27 PBL patients, treated in Cancer Center of Sun Yat-sen University from 1976 to 2005, were reviewed.


RESULTS
Of the 27 patients, 26 were women and 1 was man, with the age ranged from 12 to 84; 18 were at stage IE, 6 at stage IIE, and 3 at stage III/IVE; according to the WHO 2001 lymphoma classification system, 22 had B-cell lymphoma (including 17 cases of diffuse large B-cell lymphoma, 2 cases of mucosa-associated lymphoid tissue lymphoma, 1 case of marginal zone lymphoma, and 2 cases of unclassified B-cell lymphoma), 3 had peripheral T-cell lymphoma, and 2 had unclassified lymphoma. Of the 27 patients, 8 received mastectomy and chemotherapy, 12 received excision of the breast lesion and chemotherapy (the 5-year overall survival rates were 23% and 58%, P=0.006), 5 received chemotherapy alone, and 2 received lesion excision alone; 24 achieved complete remission (CR) after scheduled treatment, 1 achieved partial remission (PR), and 2 patients had progressive disease (PD). With a follow-up of 10 years and median 38 months, the 5-year overall and disease-free survival rates of the 27 patients were 47% and 23%, respectively. As to the 20 patients with high or moderate grade diseases (diffuse large B-cell lymphoma and peripheral T-cell lymphoma), the 5-year overall and disease-free survival rates were 48% and 27%, respectively. Sixteen patients had tumor relapse during the follow-up in the homolateral breast (6 cases), controlateral breast (4 cases), central nerve system (CNS) (3 cases), bone marrow (1 case), and lymph nodes (2 cases).


CONCLUSIONS
The main subtypes of PBL are diffuse large B-cell lymphoma and peripheral T-cell lymphoma. The effect of radical operation is limited in PBL; the optimal sequence is lumpectomy followed by standard anthracycline-based regimens and radiotherapy. PBL tends to relapse to CNS, therefore, CT or MR image of CNS is necessary during follow-up.
Cao
Ya-Bing
YB
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Wang
Shu-Sen
SS
Huang
Hui-Qiang
HQ
Xu
Guang-Chuan
GC
He
You-Jian
YJ
Guan
Zhong-Zhen
ZZ
Lin
Tong-Yu
TY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000628:therapy*; D018567:Breast Neoplasms, Male / Q000628:therapy; D002648:Child; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000628:therapy*; D016399:Lymphoma, T-Cell / Q000628:therapy*; D008297:Male; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000627:therapeutic use; D015996:Survival Rate; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone