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  • Title: [Primary breast lymphoma--a report of 27 cases with literature review].
    Author: Cao YB, Wang SS, Huang HQ, Xu GC, He YJ, Guan ZZ, Lin TY.
    Journal: Ai Zheng; 2007 Jan; 26(1):84-9. PubMed ID: 17222374.
    Abstract:
    BACKGROUND & OBJECTIVE: Primary breast lymphoma (PBL) is an uncommon disease with poor clinical outcome. This study was to investigate clinicopathologic features and optimal treatment of PBL. METHODS: Clinical records of 27 PBL patients, treated in Cancer Center of Sun Yat-sen University from 1976 to 2005, were reviewed. RESULTS: Of the 27 patients, 26 were women and 1 was man, with the age ranged from 12 to 84; 18 were at stage IE, 6 at stage IIE, and 3 at stage III/IVE; according to the WHO 2001 lymphoma classification system, 22 had B-cell lymphoma (including 17 cases of diffuse large B-cell lymphoma, 2 cases of mucosa-associated lymphoid tissue lymphoma, 1 case of marginal zone lymphoma, and 2 cases of unclassified B-cell lymphoma), 3 had peripheral T-cell lymphoma, and 2 had unclassified lymphoma. Of the 27 patients, 8 received mastectomy and chemotherapy, 12 received excision of the breast lesion and chemotherapy (the 5-year overall survival rates were 23% and 58%, P=0.006), 5 received chemotherapy alone, and 2 received lesion excision alone; 24 achieved complete remission (CR) after scheduled treatment, 1 achieved partial remission (PR), and 2 patients had progressive disease (PD). With a follow-up of 10 years and median 38 months, the 5-year overall and disease-free survival rates of the 27 patients were 47% and 23%, respectively. As to the 20 patients with high or moderate grade diseases (diffuse large B-cell lymphoma and peripheral T-cell lymphoma), the 5-year overall and disease-free survival rates were 48% and 27%, respectively. Sixteen patients had tumor relapse during the follow-up in the homolateral breast (6 cases), controlateral breast (4 cases), central nerve system (CNS) (3 cases), bone marrow (1 case), and lymph nodes (2 cases). CONCLUSIONS: The main subtypes of PBL are diffuse large B-cell lymphoma and peripheral T-cell lymphoma. The effect of radical operation is limited in PBL; the optimal sequence is lumpectomy followed by standard anthracycline-based regimens and radiotherapy. PBL tends to relapse to CNS, therefore, CT or MR image of CNS is necessary during follow-up.
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