Bulky disease has an impact on outcomes in primary diffuse large B-cell lymphoma of the breast: a retrospective analysis at a single institution

Fukuhara, Suguru; Watanabe, Takashi; Munakata, Wataru; Mori, Masakazu; Maruyama, Dai; Kim, Sung Won; Kobayashi, Yasuhito; Taniguchi, Hirokazu; Maeshima, Akiko Miyagi; Tanosaki, Ryuji; Matsuno, Yoshihiro; Tobinai, Kensei

doi:10.1111/j.1600-0609.2011.01679.x

Cited by 28 publications

(27 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[1,3,4,7,17,18,23] However, in line with the present study, there are studies reporting patients' age comparable to our cohort. [5,8,21,24] Some scattered reports suggested that younger patients more often had breast Burkitt's lymphoma which tended to involve bilateral breasts.…”

Section: Discussionsupporting

confidence: 90%

Primary breast lymphoma: A single-institute experience in Taiwan

Ou¹,

Shih²,

Wang³

et al. 2014

Biomed J

View full text Add to dashboard Cite

Background:Breast is an uncommon location of lymphoma involvement. The most common type of primary breast lymphoma (PBL) is diffuse large B-cell lymphoma (DLBCL). Rituximab is the widely used monoclonal antibody against CD20+ B-cell lymphoma, especially DLBCL. We aimed to analyze the clinical features, prognostic factors, and treatment outcome with or without rituximab in primary breast DLBCL. Methods:We retrospectively analyzed patients diagnosed with PBL from October 1987 to March 2012 in our hospital, excluding metastasis by whole-body computed tomography and bone marrow study. Results:Twenty-three patients were diagnosed with PBL. All were females. Eighteen patients were stage IE and five were stage IIE according to the Ann Arbor staging system. Two patients had lymphoma other than DLBCL. The median age of primary breast DLBCL patients was 48 years (range 27-79). Two were excluded from the analysis due to refusal or ineligibility for chemotherapy. No significant prognostic factor was found. Patients receiving chemotherapy with (RC) or without (C) rituximab were not significantly different in the 5-year overall survival (RC: 57.1%; C: 58.3%; p = 0.457) or progression-free survival (RC: 57.1%; C: 50.0%; p = 0.456). A high incidence of relapse in the central nervous system (CNS) (17.6%) was observed. Conclusions: In accordance with prior literature reports, our Taiwanese cohort of primary breast DLBCL seemed younger than those reported in Japan, Korea, and Western societies. Relapse in the CNS was not uncommon. The benefit of rituximab in addition to chemotherapy was not statistically significant. Treatment modality remained to be defined by further large-scale studies. (Biomed J 2014;37:321-325)

show abstract

Section: Discussionsupporting

confidence: 90%

Primary breast lymphoma: A single-institute experience in Taiwan

Ou¹,

Shih²,

Wang³

et al. 2014

Biomed J

View full text Add to dashboard Cite

show abstract

“…As a rare subentity of DLBCL, PB‐DLBCL has been shown to display characteristic patterns of relapse distinct from those of nodal DLBCL . Particularly, a high frequency of extranodal relapses in the breast and CNS has been reported in previous studies . However, due to the rarity of this disease, the current published reports on PB‐DLBCL comprise predominantly small retrospective series, with only a few large cohort studies reported so far.…”

Section: Introductionmentioning

confidence: 99%

Primary breast diffuse large B‐cell lymphoma in the rituximab era: Therapeutic strategies and patterns of failure

Song

Sun

et al. 2018

Cancer Science

View full text Add to dashboard Cite

Primary breast diffuse large B‐cell lymphoma (PB‐DLBCL) is a rare subtype of DLBCL with limited data on patterns of failure. This multicenter study aimed to define the optimum treatment strategy and patterns of failure for PB‐DLBCL patients. We retrospectively reviewed data on 108 PB‐DLBCL patients from 21 Chinese medical centers. Only patients with localized disease (involvement of breast and localized lymph nodes) were included. After a median follow‐up of 3.2 years, 32% of patients developed progression or relapse. A continuous pattern of relapse was observed, characterized by frequent late relapses in the contralateral breast and central nervous system (CNS). Although rituximab significantly reduced the overall cumulative risk of progression or relapse (5‐year cumulative risk 57% vs 24%, P = .029), it had limited effect on the reduction of breast relapse (P = .46). Consolidative radiotherapy significantly decreased the risk of breast relapse, even in the subgroup of patients treated with rituximab (5‐year cumulative risk 21.2% vs 0%, P = .012). A continuous risk of CNS progression or relapse up to 8.2 years from diagnosis was observed (10‐year cumulative risk 28.3%), with a median time to CNS relapse of 3.1 years. Neither rituximab nor prophylactic intrathecal chemotherapy significantly decreased the risk of CNS relapse. In summary, our study indicates that PB‐DLBCL has a continuous pattern of relapse, especially with frequent late relapses in the CNS and contralateral breast. Rituximab and RT confer complementary benefit in the reduction of relapse. However, neither the addition of rituximab nor prophylactic intrathecal chemotherapy could effectively prevent CNS relapse for PB‐DLBCL patients.

show abstract

“…Further, identifying a higher risk subset would be useful but difficult given the rarity of the disease. There are anecdotal data that suggest bilateral involvement [48] and tumor size >5 cm [49] [50]. Therefore, patients with breast involvement appear to be at additional risk of CNS progression, and we recommend consideration of CNS-directed prophylaxis, particularly in the presence of one or more potential additional risk factors (stage IIE, stage-modified IPI score >2, bilateral involvement, or tumor size >5 cm).…”

Section: Breastmentioning

confidence: 98%

Central Nervous System Prophylaxis in Non-Hodgkin Lymphoma: Who, What, and When?

Cheah

Seymour

2015

Curr Oncol Rep

View full text Add to dashboard Cite

Secondary central nervous system (CNS) progression in patients with non-Hodgkin lymphoma (NHL) is associated with a particularly poor prognosis. In this review, we summarize and critically evaluate the current literature to guide the practicing clinician in estimating CNS relapse risk in order to select individual patients who may benefit from CNS prophylaxis, covering histologic subtype, anatomic location, and molecular and clinical factors. We summarize the data regarding different prophylaxis strategies used and provide our recommendation regarding who should receive it, what they should receive, and when it should be administered.

show abstract

Bulky disease has an impact on outcomes in primary diffuse large B-cell lymphoma of the breast: a retrospective analysis at a single institution

Abstract: Patients with bulky disease had a poorer prognosis and recurred frequently in the CNS. CNS prophylaxis might yield better outcomes, but a larger, prospective trial is needed to elucidate the optimal initial treatment of PBL in the rituximab era.

Cited by 28 publications

References 29 publications

Primary breast lymphoma: A single-institute experience in Taiwan

Primary breast lymphoma: A single-institute experience in Taiwan

Primary breast diffuse large B‐cell lymphoma in the rituximab era: Therapeutic strategies and patterns of failure

Central Nervous System Prophylaxis in Non-Hodgkin Lymphoma: Who, What, and When?

Contact Info

Product

Resources

About