[Clinical and pathological analysis of 15 cases with primary breast lymphoma]

Primary breast lymphoma (PBL), a rare disease, is likely to be misdiagnosed, and its treatment still remains controversial. This study was to investigate the clinical and pathological features of PBL, summarize the treatment experience, and obtain a better profile of the disease.

The clinical and pathological records of 15 PBL patients admitted in the Cancer Hospital, Chinese Academy of Medical Science from January 1986 to December 2003 were analyzed.

The median age of the 15 patients was 39 years. Of all cases, 93.3%(14/15) were B-cell origin, 6.7% (1/15) were T-cell origin, 40% (6/15) were diffuse large B-cell lymphoma, and 26.6% (4/15) were mucosa associated lymphoid tissue lymphoma. No local relapse occurred in the 8 patients who were given local mastectomy combined with chemoradiotherapy, with a median follow-up of 34.5 months (ranging from 4 to 214 months). Two of the 6 patients with low grade PBL, who did not receive chemotherapy, relapsed after a short remission; 2 of the remaining 4 patients who received chemotherapy gained a constant remission, while after salvage chemoradiotherapy the other 2 gained a second remission up to now. The overall 3-, and 5-year survival rates were 88.9%, and 66.7%.

The majority of PBL was B-cell origin, diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma were the most frequent entities. Radical mastectomy was not necessary for good local control of combination of local mastectomy and chemoradiotherapy. PBL must be regarded as a kind of systemic disease in spite of its pathologic type. Chemotherapy should be included in the multi-modality treatment of PBL.