Yasmeen Tahira, Umar Sobia, Razi Mariah Mairah
Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Department of Nuclear Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
J Cancer Allied Spec. 2024 Aug 16;10(2):655. doi: 10.37029/jcas.v10i2.655. eCollection 2024.
It is uncommon for breast cancer and non-Hodgkin lymphoma to present simultaneously. An increase in the rate of simultaneous malignancy identification has resulted from adopting more sensitive staging imaging techniques.
Here, we describe a patient who was diagnosed with axillary diffuse large B cell lymphoma (DLBCL) in a cancer hospital during a staging work-up for suspected breast cancer. Breast cancer was staged as Stage IIA and DLBCL as Stage IE. She was given three cycles of rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone (R-CHOP) protocol. Interim positron emission tomography scan showed a complete metabolic response (Deauville score 2). She was given one more cycle of R-CHOP. Then, she had right breast-conserving surgery with axillary lymph node dissection in August 2023. Histopathology report showed residual disease with ductal carcinoma . She was recommended weekly paclitaxel for 12 cycles and trastuzumab and pertuzumab for 1 year. She is currently having her adjuvant systemic therapy, after which she will be planned for local radiation. Endocrine treatment will be started once chemotherapy is completed.
Complete baseline work-up per standard protocols/guidelines should be done in each malignancy. Biopsy of metastatic sites should be done wherever possible. All histopathologies should be reviewed thoroughly before treatment initiation, as they may significantly alter patient management.
乳腺癌和非霍奇金淋巴瘤同时出现的情况并不常见。采用更敏感的分期成像技术导致同时性恶性肿瘤识别率有所提高。
在此，我们描述一名患者，她在一家癌症医院进行疑似乳腺癌分期检查时被诊断为腋窝弥漫性大B细胞淋巴瘤（DLBCL）。乳腺癌分期为IIA期，DLBCL为IE期。她接受了三个周期的利妥昔单抗、环磷酰胺、长春新碱、多柔比星和泼尼松龙（R-CHOP）方案治疗。中期正电子发射断层扫描显示完全代谢缓解（Deauville评分2）。她又接受了一个周期的R-CHOP治疗。然后，她于2023年8月接受了保乳手术及腋窝淋巴结清扫术。组织病理学报告显示残留导管癌。建议她每周接受12周期紫杉醇治疗，并使用曲妥珠单抗和帕妥珠单抗治疗1年。她目前正在接受辅助全身治疗，之后将计划进行局部放疗。化疗完成后将开始内分泌治疗。
对于每一种恶性肿瘤，都应按照标准方案/指南进行完整的基线检查。只要有可能，就应对转移部位进行活检。在开始治疗前，应对所有组织病理学检查进行全面复查，因为它们可能会显著改变患者的治疗管理。
