Primary non-Hodgkin lymphoma of the breast: The mayo clinic experience

William W. Wong, Steven E. Schild, Michele Y. Halyard, Paula J. Schomberg

Research output: Contribution to journalArticle

107 Citations (Scopus)

Abstract

Background and Objectives: To retrospectively evaluate the characteristics, natural history, results of treatment, and prognostic factors for patients diagnosed with primary breast lymphoma. Methods: Between 1973 and 1998, 25 women and 1 man with the diagnosis of primary breast non-Hodgkin lymphoma (PNHLB) were seen at Mayo Clinic Rochester and Mayo Clinic Scottsdale. Patient characteristics, treatment methods, and outcome were analyzed. Results: The median follow-up for surviving patients was 6.6 years (range: 1.8-22.1 years). There were 11 low-grade NHL, 13 intermediate-grade NHL, and 2 high-grade NHL. Three patients underwent mastectomy while 23 had local excision. The Ann Arbor stage of disease included: Stage I - 21 patients, Stage II - 5 patients. Sixteen patients received radiation after surgery (15 after biopsy, 1 after mastectomy). Chemotherapy was given to 10 patients as part of the initial treatment. Four patients with low-grade disease were treated with excision only. The 5-year overall survival rate was 70% and relapse-free survival rate 42%, while local control rate was 75% and distant control rate 51%. Five-year survival and relapse-free survival rates for patients with low-grade disease were 91 and 61%, respectively. Three of four patients with low-grade disease treated with excision alone were free of local recurrence. For intermediate- and high-grade PNHLB, 5-year survival rate was 61% for those treated with chemotherapy, compared to 31 % for those without chemotherapy (P = 0.35), and the 5-year relapse-free survival rates were 49%, compared to 0%, respectively (P=0.0017). Three patients with intermediate- or high-grade disease developed central nervous system (CNS) dissemination. On univariate analysis, Ann Arbor stage was the only significant prognostic factor for survival (P = 0.0021). Conclusions: The management of PNHLB should be based on histologic grade. Patients with low-grade disease may be managed with local therapy alone. The role of chemotherapy in this group is unclear. Patients with intermediate- or high-grade disease have better outcome if chemotherapy is included. An unusual site of distant dissemination for these patients is the CNS. The only significant prognostic factor for survival is Ann Arbor stage.

Original languageEnglish (US)
Pages (from-to)19-25
Number of pages7
JournalJournal of Surgical Oncology
Volume80
Issue number1
DOIs
StatePublished - 2002

Fingerprint

Non-Hodgkin's Lymphoma
Breast
Survival Rate
Drug Therapy
Recurrence
Mastectomy
Survival
Central Nervous System Diseases
Natural History
Lymphoma
Therapeutics
Central Nervous System

Keywords

  • Breast
  • Breast lymphoma
  • Extra-nodal non-Hodgkin lymphoma
  • Lymphoma
  • Non-Hodgkin lymphoma of breast

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Wong, W. W., Schild, S. E., Halyard, M. Y., & Schomberg, P. J. (2002). Primary non-Hodgkin lymphoma of the breast: The mayo clinic experience. Journal of Surgical Oncology, 80(1), 19-25. https://doi.org/10.1002/jso.10084

Primary non-Hodgkin lymphoma of the breast : The mayo clinic experience. / Wong, William W.; Schild, Steven E.; Halyard, Michele Y.; Schomberg, Paula J.

In: Journal of Surgical Oncology, Vol. 80, No. 1, 2002, p. 19-25.

Research output: Contribution to journalArticle

Wong, WW, Schild, SE, Halyard, MY & Schomberg, PJ 2002, 'Primary non-Hodgkin lymphoma of the breast: The mayo clinic experience', Journal of Surgical Oncology, vol. 80, no. 1, pp. 19-25. https://doi.org/10.1002/jso.10084
Wong, William W. ; Schild, Steven E. ; Halyard, Michele Y. ; Schomberg, Paula J. / Primary non-Hodgkin lymphoma of the breast : The mayo clinic experience. In: Journal of Surgical Oncology. 2002 ; Vol. 80, No. 1. pp. 19-25.
@article{5697b60de17a40c2be7efdc9c41fa2bb,
title = "Primary non-Hodgkin lymphoma of the breast: The mayo clinic experience",
abstract = "Background and Objectives: To retrospectively evaluate the characteristics, natural history, results of treatment, and prognostic factors for patients diagnosed with primary breast lymphoma. Methods: Between 1973 and 1998, 25 women and 1 man with the diagnosis of primary breast non-Hodgkin lymphoma (PNHLB) were seen at Mayo Clinic Rochester and Mayo Clinic Scottsdale. Patient characteristics, treatment methods, and outcome were analyzed. Results: The median follow-up for surviving patients was 6.6 years (range: 1.8-22.1 years). There were 11 low-grade NHL, 13 intermediate-grade NHL, and 2 high-grade NHL. Three patients underwent mastectomy while 23 had local excision. The Ann Arbor stage of disease included: Stage I - 21 patients, Stage II - 5 patients. Sixteen patients received radiation after surgery (15 after biopsy, 1 after mastectomy). Chemotherapy was given to 10 patients as part of the initial treatment. Four patients with low-grade disease were treated with excision only. The 5-year overall survival rate was 70{\%} and relapse-free survival rate 42{\%}, while local control rate was 75{\%} and distant control rate 51{\%}. Five-year survival and relapse-free survival rates for patients with low-grade disease were 91 and 61{\%}, respectively. Three of four patients with low-grade disease treated with excision alone were free of local recurrence. For intermediate- and high-grade PNHLB, 5-year survival rate was 61{\%} for those treated with chemotherapy, compared to 31 {\%} for those without chemotherapy (P = 0.35), and the 5-year relapse-free survival rates were 49{\%}, compared to 0{\%}, respectively (P=0.0017). Three patients with intermediate- or high-grade disease developed central nervous system (CNS) dissemination. On univariate analysis, Ann Arbor stage was the only significant prognostic factor for survival (P = 0.0021). Conclusions: The management of PNHLB should be based on histologic grade. Patients with low-grade disease may be managed with local therapy alone. The role of chemotherapy in this group is unclear. Patients with intermediate- or high-grade disease have better outcome if chemotherapy is included. An unusual site of distant dissemination for these patients is the CNS. The only significant prognostic factor for survival is Ann Arbor stage.",
keywords = "Breast, Breast lymphoma, Extra-nodal non-Hodgkin lymphoma, Lymphoma, Non-Hodgkin lymphoma of breast",
author = "Wong, {William W.} and Schild, {Steven E.} and Halyard, {Michele Y.} and Schomberg, {Paula J.}",
year = "2002",
doi = "10.1002/jso.10084",
language = "English (US)",
volume = "80",
pages = "19--25",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "1",

}

TY - JOUR

T1 - Primary non-Hodgkin lymphoma of the breast

T2 - The mayo clinic experience

AU - Wong, William W.

AU - Schild, Steven E.

AU - Halyard, Michele Y.

AU - Schomberg, Paula J.

PY - 2002

Y1 - 2002

N2 - Background and Objectives: To retrospectively evaluate the characteristics, natural history, results of treatment, and prognostic factors for patients diagnosed with primary breast lymphoma. Methods: Between 1973 and 1998, 25 women and 1 man with the diagnosis of primary breast non-Hodgkin lymphoma (PNHLB) were seen at Mayo Clinic Rochester and Mayo Clinic Scottsdale. Patient characteristics, treatment methods, and outcome were analyzed. Results: The median follow-up for surviving patients was 6.6 years (range: 1.8-22.1 years). There were 11 low-grade NHL, 13 intermediate-grade NHL, and 2 high-grade NHL. Three patients underwent mastectomy while 23 had local excision. The Ann Arbor stage of disease included: Stage I - 21 patients, Stage II - 5 patients. Sixteen patients received radiation after surgery (15 after biopsy, 1 after mastectomy). Chemotherapy was given to 10 patients as part of the initial treatment. Four patients with low-grade disease were treated with excision only. The 5-year overall survival rate was 70% and relapse-free survival rate 42%, while local control rate was 75% and distant control rate 51%. Five-year survival and relapse-free survival rates for patients with low-grade disease were 91 and 61%, respectively. Three of four patients with low-grade disease treated with excision alone were free of local recurrence. For intermediate- and high-grade PNHLB, 5-year survival rate was 61% for those treated with chemotherapy, compared to 31 % for those without chemotherapy (P = 0.35), and the 5-year relapse-free survival rates were 49%, compared to 0%, respectively (P=0.0017). Three patients with intermediate- or high-grade disease developed central nervous system (CNS) dissemination. On univariate analysis, Ann Arbor stage was the only significant prognostic factor for survival (P = 0.0021). Conclusions: The management of PNHLB should be based on histologic grade. Patients with low-grade disease may be managed with local therapy alone. The role of chemotherapy in this group is unclear. Patients with intermediate- or high-grade disease have better outcome if chemotherapy is included. An unusual site of distant dissemination for these patients is the CNS. The only significant prognostic factor for survival is Ann Arbor stage.

AB - Background and Objectives: To retrospectively evaluate the characteristics, natural history, results of treatment, and prognostic factors for patients diagnosed with primary breast lymphoma. Methods: Between 1973 and 1998, 25 women and 1 man with the diagnosis of primary breast non-Hodgkin lymphoma (PNHLB) were seen at Mayo Clinic Rochester and Mayo Clinic Scottsdale. Patient characteristics, treatment methods, and outcome were analyzed. Results: The median follow-up for surviving patients was 6.6 years (range: 1.8-22.1 years). There were 11 low-grade NHL, 13 intermediate-grade NHL, and 2 high-grade NHL. Three patients underwent mastectomy while 23 had local excision. The Ann Arbor stage of disease included: Stage I - 21 patients, Stage II - 5 patients. Sixteen patients received radiation after surgery (15 after biopsy, 1 after mastectomy). Chemotherapy was given to 10 patients as part of the initial treatment. Four patients with low-grade disease were treated with excision only. The 5-year overall survival rate was 70% and relapse-free survival rate 42%, while local control rate was 75% and distant control rate 51%. Five-year survival and relapse-free survival rates for patients with low-grade disease were 91 and 61%, respectively. Three of four patients with low-grade disease treated with excision alone were free of local recurrence. For intermediate- and high-grade PNHLB, 5-year survival rate was 61% for those treated with chemotherapy, compared to 31 % for those without chemotherapy (P = 0.35), and the 5-year relapse-free survival rates were 49%, compared to 0%, respectively (P=0.0017). Three patients with intermediate- or high-grade disease developed central nervous system (CNS) dissemination. On univariate analysis, Ann Arbor stage was the only significant prognostic factor for survival (P = 0.0021). Conclusions: The management of PNHLB should be based on histologic grade. Patients with low-grade disease may be managed with local therapy alone. The role of chemotherapy in this group is unclear. Patients with intermediate- or high-grade disease have better outcome if chemotherapy is included. An unusual site of distant dissemination for these patients is the CNS. The only significant prognostic factor for survival is Ann Arbor stage.

KW - Breast

KW - Breast lymphoma

KW - Extra-nodal non-Hodgkin lymphoma

KW - Lymphoma

KW - Non-Hodgkin lymphoma of breast

UR - http://www.scopus.com/inward/record.url?scp=0036254993&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036254993&partnerID=8YFLogxK

U2 - 10.1002/jso.10084

DO - 10.1002/jso.10084

M3 - Article

C2 - 11967901

AN - SCOPUS:0036254993

VL - 80

SP - 19

EP - 25

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 1

ER -