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.

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