Department of Medical Oncology, Dr. Lutfi Kirdar Education and Research Hospital, Istanbul, Turkey.
Arch Gynecol Obstet. 2011 Aug;284(2):405-9. doi: 10.1007/s00404-010-1683-y. Epub 2010 Sep 26.
Non-Hodgkin lymphomas of the breast are uncommon cancers that occur as either primary extranodal diseases or secondary localizations of a systemic disease. The term "primary breast lymphoma" (PBL) is used to define malignant lymphomas primarily occurring in the breast in the absence of previously detected lymphoma localizations. In this report, we analyzed nine patients with primary diffuse large B cell lymphoma (DLBCL) of breast.
Patients with newly diagnosed PBLs treated between 1997 and 2009 in five institutions were retrospectively evaluated.
The median age of the patients with PBL was 49 years (range 30-82 years), and four patients had left-sided and five had right-sided disease. All of the nine patients were classified as DLBCL. Five patients with DLBCL received chemotherapy followed by involved-field or elective-field radiotherapy and four received chemotherapy alone. Complete remission (CR) following primary treatment for all patients with PBL except for two cases was obtained. In two patients, recurrence occurred. At the median follow-up of 24.2 months, the 5-year OS rate was 76.2%. Univariate analysis indicated that age, ECOG PS, clinical stage, international prognostic index score, lactate dehydrogenase levels and the presence of B symptoms were not important prognostic factors in our study.
Our series contained a small sample size, but it is interesting because it included only DLBCL cases. However, definitive conclusions about treatment and follow-up options of patients cannot be made in such a small series of patients. There are very few reports of patients with PBL treated with R-CHOP rather than CHOP alone. The followup is probably still too short and sample size very few to know how R-CHOP compares with CHOP-treated patients in other series, but this is definitely worth looking at in more detail when reasonable median follow-up has been achieved and sample size are sufficient.
乳腺非霍奇金淋巴瘤是一种罕见的癌症,可表现为原发性结外疾病或系统性疾病的局部继发性病变。“原发性乳腺淋巴瘤”(PBL)是指在未发现先前淋巴瘤局部病变的情况下,主要发生在乳腺的恶性淋巴瘤。在本报告中,我们分析了 9 例原发性弥漫性大 B 细胞淋巴瘤(DLBCL)乳腺患者。
回顾性分析了 5 家机构在 1997 年至 2009 年间诊断为 PBL 的初治患者。
PBL 患者的中位年龄为 49 岁(范围 30-82 岁),4 例为左侧,5 例为右侧。9 例患者均被分类为 DLBCL。5 例 DLBCL 患者接受化疗后接受累及野或选择性野放疗,4 例仅接受化疗。除 2 例外,所有 PBL 患者在原发性治疗后均获得完全缓解(CR)。2 例患者复发。在中位随访 24.2 个月时,5 年 OS 率为 76.2%。单因素分析表明,年龄、ECOG PS、临床分期、国际预后指数评分、乳酸脱氢酶水平和 B 症状的存在不是本研究中的重要预后因素。
我们的系列包含一个小样本量,但很有趣,因为它只包括 DLBCL 病例。然而,在这样一个小系列患者中,不能对患者的治疗和随访选择做出明确的结论。用 R-CHOP 而不是 CHOP 单独治疗 PBL 的患者报告很少。随访时间可能仍然太短,样本量太少,无法知道 R-CHOP 与其他系列中接受 CHOP 治疗的患者相比如何,但当达到合理的中位随访时间且样本量足够时,这绝对值得更详细地研究。