Division of Surgical Oncology, Department of Surgery, Mount Sinai Medical Center, Miami Beach, Florida.
JAMA Surg. 2014 Jan;149(1):91-3. doi: 10.1001/jamasurg.2013.2283.
In our retrospective study covering the past 30 years at a tertiary cancer care institution, we review 30 patients with primary breast lymphoma (stage I or II) and analyze the different treatment modalities. All 30 patients had unilateral disease, and the median age was 67.5 years. Two patients refused treatment and, hence, were excluded from our study. Of the 28 remaining patients, 11 (39%) were treated with a single treatment modality, and 17 (61%) underwent different combinations of surgery, radiation therapy, and chemotherapy. Seventeen patients underwent a surgical resection as the primary modality or as part of a multimodality therapy. Seven patients (25%) experienced a local or distal recurrence of the disease. Of these 7 patients, 6 underwent surgery as the primary treatment or as part of a combined treatment modality, and 1 underwent radiation therapy only. Eighteen patients (64%) died during the follow-up period ranging from 6 to 230 months, but only 5 of these 18 patients (28% [18% of all patients]) died of disease-specific causes. Of the 2 patients who were only treated with chemotherapy, 1 had primary breast lymphoma that never went into remission. In our study, surgery as the primary modality therapy or as part of a multimodality therapy for primary breast lymphoma is associated with a higher rate of treatment failure, whereas a combination of chemotherapy and local radiation therapy provides the best results. However, because our sample size is small, for such a rare neoplasm, definitive treatment recommendations are difficult to determine.
在我们对一家三级癌症治疗机构过去 30 年的回顾性研究中,我们回顾了 30 例原发性乳腺淋巴瘤(I 期或 II 期)患者,并分析了不同的治疗方式。所有 30 例患者均为单侧疾病,中位年龄为 67.5 岁。有 2 例患者拒绝治疗,因此被排除在我们的研究之外。在其余 28 例患者中,有 11 例(39%)采用单一治疗方式,17 例(61%)采用手术、放疗和化疗的不同组合。17 例患者采用手术作为主要治疗方式或多模式治疗的一部分。7 例(25%)患者出现疾病局部或远处复发。在这 7 例患者中,有 6 例作为主要治疗或联合治疗方式接受了手术,1 例仅接受了放疗。在随访期间(6 至 230 个月),18 例患者(64%)死亡,但其中仅 5 例(18%)死于疾病特异性原因。在仅接受化疗的 2 例患者中,1 例原发性乳腺淋巴瘤从未缓解。在我们的研究中,手术作为主要治疗方式或多模式治疗的一部分与更高的治疗失败率相关,而化疗联合局部放疗提供了最佳的结果。然而,由于我们的样本量较小,对于如此罕见的肿瘤,很难确定明确的治疗建议。