Beyond The Usual Suspects: Primary Breast Lymphoma Incidentally Detected With Routine Mammographic Screening.

Area of Science:

• Oncology
• Hematology
• Diagnostic Imaging

Background:

• Primary breast lymphoma (PBL) is a rare malignancy, accounting for <1% of lymphomas and 0.5% of breast cancers.
• B-cell lymphomas are most common, with diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL) as frequent subtypes.

Purpose of the Study:

• To present a case of stage III follicular lymphoma of the breast.
• To discuss the diagnostic considerations and management of primary breast lymphoma.

Main Methods:

• A 74-year-old woman presented with a mammographically detected breast mass.
• Diagnostic workup included ultrasound, biopsy, PET scan, and lymph node biopsy.
• Immunohistochemistry confirmed B-cell markers (CD20, CD10, Bcl-6, Bcl-2).

Main Results:

• Biopsy confirmed classic follicular lymphoma (FL) in the right breast.
• Staging revealed additional disease in the left periaortic lymph node, classifying it as stage III FL.
• The patient was asymptomatic with favorable prognostic markers (normal beta-2 microglobulin and LDH).

Conclusions:

• Primary breast lymphoma diagnosis can be challenging.
• Active surveillance is a viable management option for asymptomatic patients with indolent disease and low tumor burden.
• Personalized management is crucial for primary breast lymphoma.