Hodgkin's disease involving the breast and chest wall

Eighteen patients with Hodgkin's disease involving the breast or chest wall were identified from the M. D. Anderson Hospital and Tumor Institute pathology files from 1962 through 1984. All of these cases were nodular sclerosing Hodgkin's disease. Nine of the 18 patients had Hodgkin's disease involving the breast or chest wall at initial presentation. The remaining nine cases represented recurrences involving the breast or chest wall. Breast or chest wall involvement represented extranodal extension and/or involvement of another supradiaphragmatic lymph node group. No marked difference in survival was found between the initial and recurrent groups. Those patients with breast involvement had a better prognosis than those with chest wall involvement. Hodgkin's disease involving the breast or chest wall as an initial presentation or a recurrence does not necessarily indicate an accelerated phase of the disease. Breast or chest wall involvement is probably due to Hodgkin's disease involving the intramammary or internal mammary lymph nodes, or is due to direct mediastinal extension into the chest wall.