Beyond the ordinary: primary breast lymphoma with diagnostic and therapeutic challenges

Primary breast lymphoma (PBL) is a rare neoplasm, accounting for ˂1% of all breast cancers. Most cases are of B-cell phenotype and typically present as a painless breast mass. Imaging findings are often non-specific, mimicking benign pathology, and diagnosis is confirmed through histopathological analysis. While no standardized treatment guidelines exist, surgery plays a limited role, with the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen, with or without radiotherapy, being commonly employed. Here, we present a rare case of PBL in a middle-aged African female involving the left breast, predominantly toward the axillary tail. She presented with a painless mass, and the diagnosis was confirmed by histology. The patient is currently undergoing CHOP chemotherapy with significant regression of clinical symptoms and no adverse effects reported. This case underscores the importance of early referral to a tertiary center for histopathological evaluation and timely initiation of appropriate therapy.