Primary breast diffuse large B-cell lymphoma: treatment strategies and patterns of failure<sup/>

Leuk Lymphoma. 2018 Dec;59(12):2896-2903. doi: 10.1080/10428194.2018.1460825. Epub 2018 Apr 26.

Abstract

Treatment strategies and outcomes were assessed in 25 patients with primary breast diffuse large B-cell lymphoma (PB-DLBCL) treated between 1995 and 2016. We specifically investigated the timing of recurrence, and the roles of radiotherapy (RT) and central nervous system prophylaxis (CNS PPX). Fifty-two percent of patients received RT, and 28% received CNS PPX. Fourteen patients (56%) experienced recurrence, with 76% of relapses occurring ≥24 months after diagnosis, in contrast to reports supporting the use of 24-month event-free survival as a surrogate endpoint in the general DLBCL population. Use of RT was associated with a trend toward improved progression-free survival (PFS). Twenty percent of patients experienced CNS relapse, with no clear benefit to CNS PPX. These data emphasize the importance of long-term follow-up for PB-DLBCL patients, suggest a PFS benefit with the addition of RT, and highlight high rates of CNS relapse.

Keywords: Diffuse large B-cell lymphoma; breast cancer; intrathecal chemotherapy; lymphoma; radiotherapy; survivorship.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast / pathology
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Breast Neoplasms, Male / mortality
  • Breast Neoplasms, Male / pathology
  • Breast Neoplasms, Male / therapy*
  • Central Nervous System Neoplasms / prevention & control
  • Central Nervous System Neoplasms / secondary
  • Chemoradiotherapy / methods
  • Chemoradiotherapy / statistics & numerical data
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / mortality
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Lymphoma, Large B-Cell, Diffuse / therapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / prevention & control
  • Progression-Free Survival
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Failure