Background: Breast lymphoma (BL) is a rare entity. Although mimicking clinical presentation and radiological features of epithelial breast malignancies, prognosis and treatment management are different. Here we report our single institution experience in such population.Methods: The database of our pathology institute was retrospectively searched for breast neoplasms coded as lymphoma from January 2000 to January 2017. The assessed data were: gender, age at diagnosis, laterality, stage (primary or secondary), histopathological diagnosis and grading (high vs. low) treatment, recurrence and survival status. Progression-free survival (PFS), overall survival (OS) and 5-year recurrence rate were estimated. An exploratory analysis comparing survival (PFS, OS and 5-year recurrence rate) between high- and low-grade histotypes and primary and secondary stages was performed.Results: Fifteen patients were included in the analysis. All patients were affected by B-cell type lymphomas; the most frequent subtype was diffuse large B-cell lymphoma (DLBCL). Patients affected by high-grade lymphomas were treated with polychemotherapy followed in about half of cases by consolidative ipsilateral breast radiotherapy. Patients affected by low-grade lymphomas were treated with local treatment only (surgical resection +/- radiotherapy). No patient received radical surgery or axillary dissection. At a median follow up of 9 years, four patients had relapsed (all affected by high-grade lymphomas) with central nervous system (CNS) involved in half cases. Both median PFS and OS were not reached, but a slight trend toward a better survival was noticed in favor of primary breast lymphoma (PBL), while a clearer survival benefit was observed in the low-grade cohort. The estimated 5-year survival rate was 77% within the whole population, 78% vs. 66% for primary vs. secondary and 100% vs. 66% for low-grade vs. high-grade BL.Conclusions: Our data concerning clinical and pathological features are consistent with those previously reported. Management of disease was based on histology. Although being a rare disease it is mandatory to take it into account for differential diagnosis since treatment and prognosis differs widely from primary breast malignancies.

Orlandi, A., Sanchez, A. M., Calegari, M. A., D'archi, S., Santoro, A., Di Leone, A., Mule, A., Arena, V., Masetti, R., Barone, C., Franceschini, G., Diagnosis and management of breast lymphoma: A single-institution retrospective analysis, <<TRANSLATIONAL CANCER RESEARCH>>, 2018; 7 (S3): S272-S280. [doi:10.21037/tcr.2017.11.10] [http://hdl.handle.net/10807/143205]

Diagnosis and management of breast lymphoma: A single-institution retrospective analysis

Orlandi A.;Calegari M. A.;Santoro A.;Di Leone A.;Mule A.;Arena V.;Masetti R.;Barone C.;Franceschini G.
2018

Abstract

Background: Breast lymphoma (BL) is a rare entity. Although mimicking clinical presentation and radiological features of epithelial breast malignancies, prognosis and treatment management are different. Here we report our single institution experience in such population.Methods: The database of our pathology institute was retrospectively searched for breast neoplasms coded as lymphoma from January 2000 to January 2017. The assessed data were: gender, age at diagnosis, laterality, stage (primary or secondary), histopathological diagnosis and grading (high vs. low) treatment, recurrence and survival status. Progression-free survival (PFS), overall survival (OS) and 5-year recurrence rate were estimated. An exploratory analysis comparing survival (PFS, OS and 5-year recurrence rate) between high- and low-grade histotypes and primary and secondary stages was performed.Results: Fifteen patients were included in the analysis. All patients were affected by B-cell type lymphomas; the most frequent subtype was diffuse large B-cell lymphoma (DLBCL). Patients affected by high-grade lymphomas were treated with polychemotherapy followed in about half of cases by consolidative ipsilateral breast radiotherapy. Patients affected by low-grade lymphomas were treated with local treatment only (surgical resection +/- radiotherapy). No patient received radical surgery or axillary dissection. At a median follow up of 9 years, four patients had relapsed (all affected by high-grade lymphomas) with central nervous system (CNS) involved in half cases. Both median PFS and OS were not reached, but a slight trend toward a better survival was noticed in favor of primary breast lymphoma (PBL), while a clearer survival benefit was observed in the low-grade cohort. The estimated 5-year survival rate was 77% within the whole population, 78% vs. 66% for primary vs. secondary and 100% vs. 66% for low-grade vs. high-grade BL.Conclusions: Our data concerning clinical and pathological features are consistent with those previously reported. Management of disease was based on histology. Although being a rare disease it is mandatory to take it into account for differential diagnosis since treatment and prognosis differs widely from primary breast malignancies.
Inglese
http://tcr.amegroups.com/article/download/17996/pdf
Orlandi, A., Sanchez, A. M., Calegari, M. A., D'archi, S., Santoro, A., Di Leone, A., Mule, A., Arena, V., Masetti, R., Barone, C., Franceschini, G., Diagnosis and management of breast lymphoma: A single-institution retrospective analysis, <>, 2018; 7 (S3): S272-S280. [doi:10.21037/tcr.2017.11.10] [http://hdl.handle.net/10807/143205]
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