Shao Y B, Sun X F, He Y N, Liu C J, Liu H
Department of Breast Oncology, The Affiliated Cancer Hospital of Zhengzhou University, 127 Dongming Road, Zhengzhou, 450008, China.
Med Oncol. 2015 Feb;32(2):448. doi: 10.1007/s12032-014-0448-z. Epub 2015 Jan 9.
Primary breast lymphoma (PBL) is a rare disease accounting for 0.4-0.5 % of all breast malignancies. Accumulating evidence indicates that the diagnosis, prognostic factors, and optimal management of PBL are difficult. The present study aims to investigate the clinicopathological features and optimal treatment of PBL and to evaluate the institutional experience in this patient population. A total of 30 patients with PBL from January 2002 to December 2012 treated in He'nan Province Tumor Hospital were selected. The patients' clinical and pathological characteristics, treatment and response data, patterns of recurrence, and outcomes were retrospectively analyzed, and the relevant literatures were reviewed. All the cases were female, and the median age was 45. Diffuse large B cell lymphoma was the most common histological subtype seen in 23 of 30 patients. With a median follow-up time 32 months, median OS was 42 months (95 % CI 25-58 months), with 5-year OS rates 48 % (95 % CI 36-59 %). The median PFS was 14 months (95 % CI 6-30 months), with 5-year PFS rates 32 % (95 % CI 20-45 %). The prognostic factors that retained statistical significance for OS were IPI (P < 0.001), age (P = 0.04), and stage (P < 0.001). For PFS, significant prognostic factors were IPI (P = 0.01), radiotherapy given (P = 0.02) and stage (P = 0.02). PBL appears to have a worse prognosis. The present treatment method for PBL is a comprehensive way of diagnostic surgery together with radiotherapy and chemotherapy.
原发性乳腺淋巴瘤(PBL)是一种罕见疾病,占所有乳腺恶性肿瘤的0.4 - 0.5%。越来越多的证据表明,PBL的诊断、预后因素及最佳治疗方案都颇具难度。本研究旨在探讨PBL的临床病理特征及最佳治疗方法,并评估该患者群体的机构治疗经验。选取了2002年1月至2012年12月在河南省肿瘤医院接受治疗的30例PBL患者。对患者的临床和病理特征、治疗及反应数据、复发模式和结局进行回顾性分析,并复习相关文献。所有病例均为女性,中位年龄为45岁。弥漫性大B细胞淋巴瘤是最常见的组织学亚型,30例患者中有23例为此型。中位随访时间为32个月,中位总生存期(OS)为42个月(95%可信区间25 - 58个月),5年总生存率为48%(95%可信区间36 - 59%)。中位无进展生存期(PFS)为14个月(95%可信区间6 - 30个月),5年无进展生存率为32%(95%可信区间20 - 45%)。对总生存期具有统计学意义的预后因素为国际预后指数(IPI)(P < 0.001)、年龄(P = 0.04)和分期(P < 0.001)。对于无进展生存期,显著的预后因素为IPI(P = 0.01)、是否接受放疗(P = 0.02)和分期(P = 0.02)。PBL的预后似乎较差。目前PBL的治疗方法是诊断性手术联合放疗和化疗的综合治疗方式。