Primary Breast Lymphoma (PBL)
Introduction
Primary breast lymphoma is a very rare form of breast cancer accounting in less than 0.5% of all breast malignancies.
Diffuse Large B-cell lymphoma is the most common histological presentation.
Breast lymphoid cells occurs from the mucosa-associated lymphoid tissue (MALT). It can also originate from the lymphatic tissue present within the breast adjacent to the ducts and lobule.
Variants of Breast Lymphomas
- Diffuse large B-cell lymphoma (most common up to 50% presentation)
- Follicular lymphoma
- MALT lymphoma
- Burkitt’s lymphoma
- Burkitt-like lymphoma
- Anaplastic large cell lymphoma
Presentation, Diagnosis and Investigation
- Presentation is similar to that of breast carcinoma in women age 50- 60 years of age.
- Mammogram and Breast ultrasound
- US guided core biopsy
- CT scan whole body staging
- Bone marrow biopsies
Staging and Classification
- Ann Arbor staging
Immunohistochemistry
- CD 20 positive
- Leucocyte common antigen – positive
Treatment
- Surgery is not often beneficial – carries high morbidity rate. Surgery reserves for mainly diagnosis and axillary surgery has no role in treatment of PBL
- CHOP chemotherapy regime (cyclophosphamide, doxorubicin, vincristine and prednisolone)
- Field Radiation therapy