TY - JOUR
T1 - Primary diffuse large B-cell lymphoma of the breast
T2 - Prognostic factors and outcomes of a study by the international extranodal lymphoma study group
AU - Ryan, Gail
AU - Martinelli, G.
AU - Kuper-Hommel, M.
AU - Tsang, R.
AU - Pruneri, G.
AU - Yuen, K.
AU - Roos, D.
AU - Lennard, A.
AU - Devizzi, L.
AU - Crabb, S.
AU - Hossfeld, D.
AU - Pratt, G.
AU - Dell'Olio, M.
AU - Choo, S. P.
AU - Bociek, R. G.
AU - Radford, J.
AU - Lade, S.
AU - Gianni, A. M.
AU - Zucca, E.
AU - Cavalli, F.
AU - Seymour, J. F.
PY - 2008/2
Y1 - 2008/2
N2 - Background: Primary diffuse large B-cell lymphoma (DLBCL) of breast is rare. We aimed to define clinical features, prognostic factors, patterns of failure, and treatment outcomes. Patients and methods: A retrospective international study of 204 eligible patients presenting to the International Extranodal Lymphoma Study Group-affiliated institutions from 1980 to 2003. Results: Median age was 64 years, with 95% of patients presenting with unilateral disease. Median overall survival (OS) was 8.0 years, and median progression-free survival 5.5 years. In multifactor analysis, favourable International Prognostic Index score, anthracycline-containing chemotherapy, and radiotherapy (RT) were significantly associated with longer OS (each P ≤ 0.03). There was no benefit from mastectomy, as opposed to biopsy or lumpectomy only. At a median follow-up time of 5.5 years, 37% of patients had progressed - 16% in the same or contralateral breast, 5% in the central nervous system, and 14% in other extranodal sites. Conclusions: The combination of limited surgery, anthracycline-containing chemotherapy, and involved-field RT produced the best outcome in the pre-rituximab era. A prospective trial on the basis of these results should be pursued to confirm these observations and to determine whether the impact of rituximab on the patterns of relapse and outcome parallels that of DLBCL presenting at other sites.
AB - Background: Primary diffuse large B-cell lymphoma (DLBCL) of breast is rare. We aimed to define clinical features, prognostic factors, patterns of failure, and treatment outcomes. Patients and methods: A retrospective international study of 204 eligible patients presenting to the International Extranodal Lymphoma Study Group-affiliated institutions from 1980 to 2003. Results: Median age was 64 years, with 95% of patients presenting with unilateral disease. Median overall survival (OS) was 8.0 years, and median progression-free survival 5.5 years. In multifactor analysis, favourable International Prognostic Index score, anthracycline-containing chemotherapy, and radiotherapy (RT) were significantly associated with longer OS (each P ≤ 0.03). There was no benefit from mastectomy, as opposed to biopsy or lumpectomy only. At a median follow-up time of 5.5 years, 37% of patients had progressed - 16% in the same or contralateral breast, 5% in the central nervous system, and 14% in other extranodal sites. Conclusions: The combination of limited surgery, anthracycline-containing chemotherapy, and involved-field RT produced the best outcome in the pre-rituximab era. A prospective trial on the basis of these results should be pursued to confirm these observations and to determine whether the impact of rituximab on the patterns of relapse and outcome parallels that of DLBCL presenting at other sites.
KW - Anthracycline-based chemotherapy
KW - Breast
KW - Large B-cell lymphoma
KW - Radiotherapy
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U2 - 10.1093/annonc/mdm471
DO - 10.1093/annonc/mdm471
M3 - Article
C2 - 17932394
AN - SCOPUS:38849086608
SN - 0923-7534
VL - 19
SP - 233
EP - 241
JO - Annals of Oncology
JF - Annals of Oncology
IS - 2
ER -