Localized non-Hodgkin's lymphoma of the breast

Chart review identified 18 patients seen at Memorial Hospital from 1970 to 1984 with primary non-Hodgkin's lymphoma localized to the breast. Sixteen involved the breast alone (Stage IE), whereas two also involved ipsilateral axillary lymph nodes (Stage IIE). None had B symptoms. Histologic subtypes included 11 diffuse histiocytic, 4 diffuse poorly differentiated, 2 diffuse mixed and one nodular mixed. Thirteen patients (72%) are alive with 55 months median follow-up (11 months-14 years). Three patients died with recurrent disease at less than 2 years, one recurred at 4 years and died 6 years after diagnosis, and one died at 30 months without clinical evidence of disease. Seven (39%) have remained continuously disease-free (11 months-11 years; median, 54 months). Of the clinical Stage I patients, 1 of 3 treated with mastectomy alone recurred in the scar, whereas 1 of 12 treated with irradiation alone recurred locally. Thus, radiation therapy alone achieved good local control, although distant relapses remain a problem in these clinically staged patients. Overall, the outcome of clinically localized non-Hodgkin's lymphoma of the breast is similar to that for localized lymphoma in other sites.