Primary Lymphoma of the Breast

  • Current management strategies for primary breast lymphoma are largely based on:
    • Results published in small, single-institution series
  • Historically, primary breast lymphoma was treated with:
    • Modified radical mastectomy with or without adjuvant chemotherapy or radiotherapy:
      • Treatment strategies had focused on anthracycline-based chemotherapy with or without consolidative radiotherapy
  • Current treatment guidelines dictate:
    • That surgery should be reserved for
      • Obtaining adequate tissue for diagnosis, if needed, and:
        • Should not be regarded as a therapeutic modality in the treatment of this disease:
          • In several series, surgery has been associated with worse outcomes
      • Some histologies may be amenable to localized surgery so understanding the disease pathology is important in decision making
      • While axillary nodal status is an important prognosticator:
        • There are no definitive guidelines regarding how to stage the axilla:
          • In addition to CT scan, axillary ultrasound with percutaneous biopsy is frequently used
      • Sentinel lymph node biopsy has not been studied in this malignancy and currently has no role in its workup
  • References
    • Aviles A, Delgado S, Nambo MJ, Neri N, Murillo E, Cleto S. Primary breast lymphoma: results of a controlled clinical trial. Oncology. 2005;69(3):256-260.
    • Aviv A, Tadmor T, Polliack A. Primary diffuse large B-cell lymphoma of the breast: looking at pathogenesis, clinical issues and therapeutic options. Ann Oncol. 2013;24(9):2236-2244.
    • el-Ghazawy IM, Singletary SE. Surgical management of primary lymphoma of the breast. Ann Surg. 1991;214(6):724-726.
    • Jennings WC, Baker RS, Murray SS, et al. Primary breast lymphoma: the role of mastectomy and the importance of lymph node status. Ann Surg. 2007;245(5):784-789.

#Arrangoiz #BreastSurgeon #CancerSurgeon #BreastCancer #BreastLymphoma #PrimaryLymphomaoftheBreast #CASO #Miami #CenterforAdvancedSurgicalOncology

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