Lymphoma of the Breast
Pathology
Lymphoma is a very uncommon tumour in the breast. Most lymphomas of the breast are diffuse large B cell lymphoma. The remainder include Burkitt lymphoma, extranodal marginal zone lymphoma, follicular lymphoma, and a variety of rare types.
Diagnosis
Patients present similarly to adenocarcinoma of the breast, either with an enlarging painless mass or through screening. Importantly, about 10% of cases are bilateral.
Management
Management is as per lymphoma at other sites and depends on the extent of disease (ie. localised versus disseminated) and aggressiveness.
- Localised DLBCL should be managed with R-CHOP x 3 + involved field radiotherapy or with R-CHOP x 6 also with radiotherapy; R-CHOP x 6-8 may be used in younger women to avoid radiation toxicity.
- Localised follicular or extranodal lymphoma should be managed with radiotherapy alone (30 Gy in 15#)
- Extensive disease of any type should be managed with intensive chemotherapy or palliation depending on symptoms
