Skip to main content

Advertisement

Log in

Treatment and survival of 38 female breast lymphomas: a population-based study with clinical and pathological reviews

  • Original Article
  • Published:
Annals of Hematology Aims and scope Submit manuscript

Abstract

Breast lymphomas are rare and consensus about their treatment is lacking. A population-based study of 38 breast lymphomas, registered in the databases of two Comprehensive Dutch Cancer Centers from 1981 to 1999, was performed. The median age of all female patients was 65 years (20–92): 25 patients had localized and 13 patients had disseminated lymphoma. The most common type was diffuse large B-cell lymphoma (DLBCL), which accounted for 17 of the localized and 4 of the disseminated cases. Burkitt's lymphoma (BL), three being disseminated, was found in four patients. There were six extranodal marginal zone lymphomas (ENMZL), three being localized. Seven DLBCL and one BL showed additional histological features of mucosa-associated lymphoid tissue (MALT) lymphoma. Localized aggressive lymphomas treated with surgery and/or radiation therapy had relapse rates of 100% and 67%, respectively. Cyclophosphamide, hydroxydaunomycin, vincristine, and prednisone (CHOP)-like chemotherapy with or without local irradiation led to 17% relapses in patients with localized aggressive lymphoma. Median follow-up time was 32 months (0.6–218); 37% of the patients relapsed and 24% had progressive disease. Response to salvage regimens, given to 91% of the patients with recurrent disease, was poor. The 2-year overall survival rate was 63%, 72% for patients with localized disease, and 46% for patients with disseminated lymphoma. The majority of breast lymphomas are localized aggressive lymphomas that should be treated initially with CHOP-like chemotherapy with or without irradiation. The initial choice of treatment is very important because response to salvage regimens is poor.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.

Similar content being viewed by others

References

  1. Abbondanzo SL, Seidman JD, Lefkowitz M, et al. (1996) Primary diffuse large B-cell lymphoma of the breast. A clinicopathologic study of 31 cases. Pathol Res Pract 192:37–43

    CAS  PubMed  Google Scholar 

  2. Adair FE, Herrmann JB (1944) Primary lymphosarcoma of the breast. Surgery 16:836–853

    Google Scholar 

  3. Antic N, Colovic M, Cemerikic V, et al. (2000) Disseminated Burtkitt's like lymphoma during pregnancy. Med Oncol 17:233–236

    CAS  PubMed  Google Scholar 

  4. Aozasa K, Ohsawa M, Saeki K, et al. (1992) Malignant lymphoma of the breast. Immunologic type and association with lymphocytic mastopathy. Am J Clin Pathol 97:699–704

    CAS  PubMed  Google Scholar 

  5. Arber DA, Simpson JF, Weiss LM, Rappaport H (1994) Non-Hodgkin's lymphoma involving the breast. Am J Surg Pathol 18:288–295

    CAS  PubMed  Google Scholar 

  6. Au WY, Chan ACL, Chow LWC, Liang R (1997) Lymphoma of the breast in Hong Kong Chinese. Hematol Oncol 15:33–38

    Article  CAS  PubMed  Google Scholar 

  7. Bannerman RHO (1966) Burkitt's tumour in pregnancy. BMJ 2:1136–1137

    Google Scholar 

  8. DeBlasio D, McCormick B, Straus D, et al. (1989) Definitive irradiation for localized non-Hodgkin's lymphoma of breast. Int J Radiat Oncol Biol Phys 17:843–846

    CAS  PubMed  Google Scholar 

  9. Bobrow LG, Richards MA, Happerfield LC, et al. (1993) Breast lymphomas: a clinicopathologic review. Hum Pathol 24:274–278

    CAS  PubMed  Google Scholar 

  10. Brogi E, Harris NL (1999) Lymphomas of the breast: pathology and clinical behavior. Semin Oncol 26:357–364

    CAS  PubMed  Google Scholar 

  11. Brustein S, Filippa DA, Kimmel M, et al. (1987) Malignant lymphoma of the breast. A study of 53 patients. Ann Surg 205:144–150

    CAS  PubMed  Google Scholar 

  12. Burke JS (1999) Are there site-specific differences among the MALT lymphomas—morphologic, clinical? Am J Clin Pathol 111:S133-S143

    Google Scholar 

  13. Cohen PL, Brooks JJ (1991) Lymphomas of the breast. A clinicopathologic and immunohistochemical study of primary and secondary cases. Cancer 67:1359–1369

    CAS  PubMed  Google Scholar 

  14. Dao AH, Adkins RBJ, Glick AD (1992) Malignant lymphoma of the breast: a review of 13 cases. Am Surg 58:792–796

    CAS  PubMed  Google Scholar 

  15. Day NE (1987) Cumulative rates and cumulative risk. In: Muir CS, Waterhouse J, Muir CS, Mach T (eds) Cancer incidence in five continents, vol V. IARC Scientific Publications, Lyon, p 88

  16. DeCosse JJ, Berg JW, Fracchia AA, Farrow JH (1962) Primary lymphosarcoma of the breast, a review of 14 cases. Cancer 15:1264–1268

    CAS  Google Scholar 

  17. Dixon JM, Lumsden AB, Krajewski A, et al. (1987) Primary lymphoma of the breast. Br J Surg 74:214–216

    CAS  PubMed  Google Scholar 

  18. Domchek SM, Hecht JL, Fleming MD, et al. (2002) Lymphomas of the breast. Primary and secondary involvement. Cancer 96:6–13

    Article  Google Scholar 

  19. Giardini R, Piccolo C, Rilke F (1992) Primary non-Hodgkin's lymphomas of the female breast. Cancer 69:725–735

    CAS  PubMed  Google Scholar 

  20. Giedsing Hansen T, Lolk Ottesen G, Tinggaard Pedersen N, Andersen JA (1992) Primary non-Hodgkin's lymphoma of the breast (PLB): a clinicopathological study of seven cases. APMIS 100:1089–1096

    PubMed  Google Scholar 

  21. Glick JH, Kim K, Earle J, O'Connell MJ (1995) An ECOG randomized phase III trial of CHOP vs. CHOP+radiotherapy for intermediate grade early stage non-Hodgkin's lymphoma. Proc Am Soc Clin Oncol 14:391

    Google Scholar 

  22. Ha CS, Dubey P, Goyal LK, et al. (1998) Localized primary non-Hodgkin lymphoma of the breast. Am J Clin Oncol 21:376–380

    Article  CAS  PubMed  Google Scholar 

  23. Harris NL, Isaacson PG (1999) What are the criteria for distinguishing MALT from non-MALT lymphoma at extranodal sites? Am J Clin Pathol 111:S126-S132

    Google Scholar 

  24. Harris NL, Jaffe ES, Diebold J, et al. (2000) Lymphoma classification—from controversy to consensus: the R.E.A.L. and WHO Classification of lymphoid neoplasms. Ann Oncol11 [Suppl 1]:3–10

  25. Hugh JC, Jackson FI, Hanson J, Poppema S (1990) Primary breast lymphoma. An immunohistologic study of 20 new cases. Cancer 66:2602–2611

    CAS  PubMed  Google Scholar 

  26. Jancar J (2000) Progress in the classification of myeloid and lymphoid neoplasms. From REAL to WHO concept. Adv Clin Pathol 4:59–76

    CAS  Google Scholar 

  27. Jeon HJ, Akagi T, Hoshida Y, et al. (1992) Primary non-Hodgkin malignant lymphoma of the breast. An immunohistochemical study of seven patients and literature review of 152 patients with breast lymphoma in Japan. Cancer 70:2451–2459

    CAS  PubMed  Google Scholar 

  28. Jones DED, D'Avignon MB, Lawrence R, et al. (1980) Burkitt's lymphoma: obstetric and gynaecologic aspects. Obstet Gynecol 56:533-536

    CAS  PubMed  Google Scholar 

  29. De Jong D, Boot H, van Heerde P, et al. (1997) Histological grading in gastric lymphoma: pretreatment criteria and clinical relevance. Gastroenterology 112:1466–1474

    PubMed  Google Scholar 

  30. Kelenyi G (1991) Malignant lymphomas of the breast. Zentralbl Pathol 137:264–269

    CAS  PubMed  Google Scholar 

  31. Kuper-Hommel MJJ, Vrints LW, Coebergh JW, Vreugdenhil G (1999) High grade MALT-lymphoma of the breast. Neth J Med 54:235–238

    Article  CAS  PubMed  Google Scholar 

  32. Lamovec J, Jancar J (1987) Primary malignant lymphoma of the breast. Lymphoma of the mucosa- associated lymphoid tissue. Cancer 60:3033–3041

    PubMed  Google Scholar 

  33. Lin Y, Govindan R, Hess JL (1997) Malignant hematopoietic breast tumors. Am J Clin Pathol 107:177–186

    CAS  PubMed  Google Scholar 

  34. Lin FL, Hsu JC, Wang TC, et al. (1993) Primary malignant lymphoma of the breast: report of two cases with literature review. Chin Med J (Taipei) 51:231–234

    Google Scholar 

  35. Liu FF, Clark RM (1986) Primary lymphoma of the breast. Clin Radiol 37:567–570

    CAS  PubMed  Google Scholar 

  36. Lyons JA, Myles J, Pohlman B, et al. (2000) Treatment and prognosis of primary breast lymphoma. A review of 13 cases. Am J Clin Oncol 23:334–336

    Article  CAS  PubMed  Google Scholar 

  37. Magrath IT (1998) Management of high grade lymphomas. Oncology 12:40–48

    CAS  Google Scholar 

  38. Mambo NC, Burke JS, Butler JJ (1977) Primary malignant lymphomas of the breast. Cancer 39:2033–2040

    CAS  PubMed  Google Scholar 

  39. Mattia AR, Ferry JA, Harris NL (1993) Breast lymphoma; a B-cell spectrum including the low grade B-cell lymphoma of mucosa associated lymphoid tissue. Am J Surg Pathol 17:574–587

    CAS  PubMed  Google Scholar 

  40. Miller TP, Dahlberg S, Cassady JR, et al. (1998) Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin's lymphoma. N Engl J Med 339:21–26

    CAS  PubMed  Google Scholar 

  41. Miller TP, Leblanc M, Spier C, et al. (2001) CHOP alone compared to CHOP plus radiotherapy for early stage aggressive non-Hodgkin's lymphomas: update of the Southwest Oncology Group randomized trial (abstract 3024). Program and abstracts of the 43rd Annual Meeting of the American Society of Hematology, December 7–11, 2001, Orlando, Fla., USA

  42. Misra A, Kapur BM, Rath GK (1991) Primary breast lymphoma. J Surg Oncol 47:265–270

    CAS  PubMed  Google Scholar 

  43. Prevot S, Hugol D, Le Tourneau A, et al. (1990) Primary non-Hodgkin's malignant lymphoma of the breast (in French). Bull Cancer 77:123–136

    CAS  PubMed  Google Scholar 

  44. Schouten JT, Weese JL, Carbone PP (1981) Lymphoma of the breast. Ann Surg 194:749–753

    CAS  PubMed  Google Scholar 

  45. Sheperd JJ, Wright DH (1967) Burkitt's tumor presenting as bilateral swelling of the breast in females of childbearing age. Br J Surg 54:776–780

    PubMed  Google Scholar 

  46. Shipp MA, Harrington DP, Anderson JR, et al. (1993) A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med 329:987–994

    PubMed  Google Scholar 

  47. Skarin AT, Dorfman DM (1997) Non-Hodgkin's lymphomas: current classification and management. Cancer J Clin 47:351–372

    CAS  Google Scholar 

  48. Smith MR, Brustein S, Straus DJ (1987) Localized non-Hodgkin's lymphoma of the breast. Cancer 59:351–354

    CAS  PubMed  Google Scholar 

  49. De Souza LJ, Talvalkar GV, Morjaria JH (1978) Primary malignant lymphoma of the breast. Indian J Cancer 15:30–35

    PubMed  Google Scholar 

  50. Tan PH, Sng ITY (1996) Breast lymphoma—a pathologic study of 14 cases. Ann Acad Med Singapore 25:783–790

    CAS  PubMed  Google Scholar 

  51. Telesinghe PU, Anthony PP (1985) Primary lymphoma of the breast. Histopathology 9:297–307

    CAS  PubMed  Google Scholar 

  52. Trojani M, Mongodin B, Seniuta P, et al. (1990) Lymphomes malins non hodgkiniens primitifs du sein; Etude de cinq cas. Ann Pathol 10:28–33

    CAS  PubMed  Google Scholar 

  53. Vianello F, Sgarabotto D, Stefani PM, et al. (1998) Primary breast lymphoma. Forum (Genova) 8:188–195

    Google Scholar 

  54. Wiseman C, Liao KT (1972) Primary lymphoma of the breast. Cancer 29:1705–1712

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We thank all hospitals participating in the registry of the Comprehensive Cancer Centers West and South for providing access to the medical records. We thank Professor P. Kluin for the revision of the pathologic slides and we thank Professor H. van Krieken for his comments on the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. J. J. Kuper-Hommel.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kuper-Hommel, M.J.J., Snijder, S., Janssen-Heijnen, M.L.G. et al. Treatment and survival of 38 female breast lymphomas: a population-based study with clinical and pathological reviews. Ann Hematol 82, 397–404 (2003). https://doi.org/10.1007/s00277-003-0664-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00277-003-0664-7

Keywords

Navigation