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Breast Lymphoma Treatment Outcomes in a Pakistani Population: 20 Years of Experience at a Single Center

  • Bano, Razia (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Zafar, Waleed (Department of Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Khan, Amina Iqbal (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Fiaz, Sohaib Adil (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Abid, Mahwish (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Chaudhary, Mohammad Zulqarnain (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Siddique, Neelam (Department of Medical Oncology Shaukat Khanum Memorial Cancer Hospital and Research Centre) ;
  • Khan, Huma Majeed (Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre)
  • Published : 2016.07.01

Abstract

Background: Breast lymphomas constitute a rare disease entity. To date, limited relevant data have been reported. We therefore here present a review of breast lymphoma patients treated at a single center over a 20 year period, focusing on histological types, treatment modalities and outcomes. Materials and Methods: We identified patients who were diagnosed and treated for breast lymphoma at a single center from January 1995 to January 2014 and extracted data regarding patients' demographics and clinical data. Results: Twenty-seven patients with breast lymphoma were identified, of which 3 were males. The median age at diagnosis was 37 years (range: 22-76 years). Chemotherapy was the main stay of treatment and 55.6% patients also received radiation to the affected breast. At our institute, only 3 patients, all with progressive disease, had surgery performed to achieve local palliation. Complete response after chemotherapy was seen in 63% patients and partial response in 7.4%, while 26% patients demonstrated disease progression. The mean follow up was 46.8 months. Seven patients (33.3%) who were alive at last follow up, as well as 1 patient who died, survived more than 5 years after diagnosis. Conclusions: Patients with breast lymphoma should receive aggressive treatment, with combination of chemotherapy and radiation therapy. Surgery should be limited for diagnosis and palliation of local symptoms in cases of progressive disease.

Keywords

Breast lymphoma;symptoms;chemotherapy;radiotherapy;outcomes;Pakistan

References

  1. Aziz Z, Rehman A, Akram M, Saeed A(1999). Non-Hodgkin's lymphoma in Pakistan: A clinicopathological profile of 175 patients. J Pak Med Assoc, 49, 11-5.
  2. Aviles A, Delgado S, Nambo MJ et al(2005). Primary breast lymphoma: results of a controlled clinical trial. Oncol, 69, 256-60. https://doi.org/10.1159/000088333
  3. Avenia N, Sanguinetti A, Cirocchi R et al(2010). Primary breast lymphomas: a multicentric experience. World J Surg Oncol, 8, 53. https://doi.org/10.1186/1477-7819-8-53
  4. Aviv A, Tadmor T, Polliack A(2013). Primary diffuse large B-cell lymphoma of the breast: Looking at pathogenesis, clinical issues and therapeutic options. Ann Oncol, 24, 2236-4. https://doi.org/10.1093/annonc/mdt192
  5. Bhurgri Y, Kayani N, Faridi N, et al (2007). Patho-epidemiology of breast cancer in Karachi '1995-1997.' Asian Pacific J Cancer Prev, 8, 215-20.
  6. Badar F, Faruqui ZS, Uddin N, et al (2011). Management of breast lesions by breast physicians in a heavily populated South Asian developing country. Asian Pac J Cancer Prev, 82, 7-2.
  7. Carbone PP, Kaplan HS, Musshoff K, et al(1971). Report of the committee on Hodgkin's disease staging classification. Cancer Res, 31, 1860-1.
  8. Fruchart C, Denoux Y, Chasle J, et al (2005). High grade primary breast lymphoma: is it a different clinical entity? Breast Cancer Res Treat, 93, 191-8. https://doi.org/10.1007/s10549-005-5088-8
  9. Guo HY, Zhao XM, Li J, et al (2008). Primary non-hodgkin's lymphoma of the breast: Eight-year follow-up experience. Int J Hematol, 87, 491-7. https://doi.org/10.1007/s12185-008-0085-4
  10. Gualio G, Chioato L, Harrington WJ, et al (2009). Primary and secondary T- cell lymphoma: clinicopathological features of 11 cases of T-Cell lymphoma. Appl Immunohistochem Mol Morphol, 17, 301-6. https://doi.org/10.1097/PAI.0b013e318195286d
  11. Hosein PJ, Maragulia JC, Salzberg MP, et al (2014). A multicenter study of primary breast diffuse large B-cell lymphoma in the rituximab era. Br J Haematol, 165, 358-3. https://doi.org/10.1111/bjh.12753
  12. Jennings WC, Baker RS, Murray RS, et al (2007). Primary breast lymphoma: The role of mastectomy and the importance of lymph node status. Ann Surg, 245, 784-9. https://doi.org/10.1097/01.sla.0000254418.90192.59
  13. Murata T, Kuroda H, Nakahama T, et al(1996). Primary non-Hodgkin malignant lymphoma of the male breast. Jpn J Clin Oncol, 26, 243-7. https://doi.org/10.1093/oxfordjournals.jjco.a023222
  14. Modi Y, Thomas D, Shaaban H, et al (2014). Nodular sclerosing Hodgkin's lymphoma with breast involvement: Case report and review of the literature. J Nat Sci Biol Med, 5, 467-9. https://doi.org/10.4103/0976-9668.136258
  15. Osuji CU, Ahaneku GI, Onwubuya EI,et al(2013). Hodgkin's lymphoma of the breast. J Cancer Res Ther, 9, 526-8. https://doi.org/10.4103/0973-1482.119369
  16. Ou CW, Shih LY, Wang PN, et al(2014). Primary breast lymphoma: A single-institute experience in Taiwan. Biomed J, 37, 321-5. https://doi.org/10.4103/2319-4170.132889
  17. Ryan G, Martinelli G, Kuper-Hommel M, et al (2008). Primary diffuse large B-cell lymphoma of the breast: Prognostic factors and outcomes of a study by the international extranodal lymphoma study group. Ann Oncol, 19, 233-1. https://doi.org/10.1093/annonc/mdm471
  18. Radkani P, Joshi D, Paramo JC, et al (2014). Primary breast lymphoma 30 years of experience with diagnosis and treatment at a single medical center. JAMA Surg, 149, 91-3. https://doi.org/10.1001/jamasurg.2013.2283
  19. Schouten J, Weese JL, Carbone PP(1981). Lymphoma of the breast. Ann Surg, 194, 749-3. https://doi.org/10.1097/00000658-198112000-00015
  20. Sabate JM , Torrubia S, Camins A, et al(2002). Lymphoma of the breast: clinical and radiological features with pathologic correlation in 28 patients. Breast J, 8, 294-4. https://doi.org/10.1046/j.1524-4741.2002.08509.x
  21. Sultan F, Aziz MT, Khokhar I, et al(2014). Development of an inhouse hospital information system in a hospital in Pakistan. Int J Med Inform, 83, 180-8. https://doi.org/10.1016/j.ijmedinf.2013.12.004
  22. Uesato M, Miyazawa Y, Gunji Y, et al(2005). Primary non-Hodgkin lymphoma of the breast: Report of a case with special reference to 380 cases in the Japanese literature. Breast Cancer, 12, 154-8. https://doi.org/10.2325/jbcs.12.154
  23. Vardar E, Ozakok G, Centinel M, et al (2005). Primary breast lymphoma cytologic diagnosis. Arch Pathol Lab Med, 129, 1705-2.
  24. Validire P, Capovilla M, Asselain B et al (2009). Primary breast non-Hodgkin's lymphoma: a large single center study of initial characteristics, natural history, and prognostic factors. Am J Hematol, 84, 133-9. https://doi.org/10.1002/ajh.21353
  25. Wiseman C, Liao KT(1972). Primary lymphoma of the breast. Cancer, 29, 1705-2. https://doi.org/10.1002/1097-0142(197206)29:6<1705::AID-CNCR2820290640>3.0.CO;2-I
  26. Wong WW , Schild SE, Halyard MY et al(2002). Primary nonhodgkin's lymphoma of breast.; the mayo clinic experience. J Surg Oncol, 80, 19-5. https://doi.org/10.1002/jso.10084
  27. Yaqoob N, Pervez S, Kayani N, et al(2006). Frequency and characteristics of breast lymphomas presenting to a tertiary care hospital, Pakistan. J Pak Med Assoc, 56, 441-3.
  28. Yang H, Lang RG, Li FU (2011). Primary breast lymphoma (PBL): A literature review. Clin Oncol Cancer Res, 8, 128-2. https://doi.org/10.1007/s11805-011-0570-z
  29. Yhim HY, Kim JS, Kang HJ, et al(2012). Matched-pair analysis comparing the outcomes of primary breast and nodal diffuse large B-cell lymphoma in patients treated with rituximab plus chemotherapy. Int J Cancer, 131, 235- 3. https://doi.org/10.1002/ijc.26352
  30. Zhao S, Zhang QY, Ma WJ et al (2011). Analysis of 31 cases of primary breast lymphoma: the effect of nodal involvement and microvascular density. Clin Lymphoma Myeloma Leuk, 11, 33-7. https://doi.org/10.3816/CLML.2011.n.004
  31. Zhong J, Di L, Zheng W(2014). Synchronous breast cancer and breast lymphoma: Two case reports and literature review. Chin J Cancer Res, 26, 355-9.