Primary lymphoma of the breast

Introduction

Primary breast lymphoma (PBL) represents a rare form of breast malignancy, with diffuse large B-cell lymphoma (DLBCL) emerging as the predominant histological subtype. Despite advancements, treatment strategies remain contentious.

Objective

This study aims to succinctly outline the clinicopathological and immunohistochemical characteristics of PBL while appraising available therapeutic modalities.

Methods

Retrospectively, 22 PBL cases from 2003 to 2021 were culled from pathological records at the Salah Azaiez Institute. Immunohistochemistry was employed to discern DLBCL subtypes.

Results

Median age stood at 58, with a predominance of 16 female patients over 6 males, notably with over 50% of women being post-menopausal. Clinical manifestation primarily involved a unilateral right-sided breast mass, with concurrent lymph node involvement detected in 10 cases at diagnosis. Radiological data were available for 6 cases, revealing DLBCL as the prevailing pathological subtype in 16 cases (73%). Non-germinal center B-cell type was notably discerned in 9 out of 16 PB-DLBC cases. Treatment modalities encompassed surgery in 5 patients, chemotherapy in 7, and radiotherapy in 3 cases. Among treated individuals, 7 experienced recurrences, 5 of them had DLBCL.

Conclusion

Despite its rarity, PBL warrants careful consideration due to its notably aggressive nature, mandating a clear distinction from breast carcinoma owing to differential therapeutic approaches and prognoses. Hence, an accurate diagnosis grounded in thorough pathological and immunohistochemical examination is imperative for tailoring optimal treatment strategies, thereby potentially enhancing outcomes.