Primary diffuse large B-cell lymphoma of the breast: Prognostic factors and outcomes of a study by the international extranodal lymphoma study group

Gail Ryan, G. Martinelli, M. Kuper-Hommel, R. Tsang, G. Pruneri, K. Yuen, D. Roos, A. Lennard, L. Devizzi, S. Crabb, D. Hossfeld, G. Pratt, M. Dell'Olio, S. P. Choo, Robert G Bociek, J. Radford, S. Lade, A. M. Gianni, E. Zucca, F. CavalliJ. F. Seymour

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)233-241
Number of pages9
JournalAnnals of Oncology
Volume19
Issue number2
DOIs
StatePublished - Feb 1 2008

Fingerprint

Lymphoma, Large B-Cell, Diffuse
Lymphoma
Breast
Outcome Assessment (Health Care)
Anthracyclines
Radiotherapy
Drug Therapy
Survival
Segmental Mastectomy
Mastectomy
Disease-Free Survival
Central Nervous System
Retrospective Studies
Biopsy
Recurrence
Rituximab

Keywords

  • Anthracycline-based chemotherapy
  • Breast
  • Large B-cell lymphoma
  • Radiotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Primary diffuse large B-cell lymphoma of the breast : Prognostic factors and outcomes of a study by the international extranodal lymphoma study group. / Ryan, Gail; Martinelli, G.; Kuper-Hommel, M.; Tsang, R.; Pruneri, G.; Yuen, K.; Roos, D.; Lennard, A.; Devizzi, L.; Crabb, S.; Hossfeld, D.; Pratt, G.; Dell'Olio, M.; Choo, S. P.; Bociek, Robert G; Radford, J.; Lade, S.; Gianni, A. M.; Zucca, E.; Cavalli, F.; Seymour, J. F.

In: Annals of Oncology, Vol. 19, No. 2, 01.02.2008, p. 233-241.

Research output: Contribution to journalArticle

Ryan, G, Martinelli, G, Kuper-Hommel, M, Tsang, R, Pruneri, G, Yuen, K, Roos, D, Lennard, A, Devizzi, L, Crabb, S, Hossfeld, D, Pratt, G, Dell'Olio, M, Choo, SP, Bociek, RG, Radford, J, Lade, S, Gianni, AM, Zucca, E, Cavalli, F & Seymour, JF 2008, 'Primary diffuse large B-cell lymphoma of the breast: Prognostic factors and outcomes of a study by the international extranodal lymphoma study group', Annals of Oncology, vol. 19, no. 2, pp. 233-241. https://doi.org/10.1093/annonc/mdm471
Ryan, Gail ; Martinelli, G. ; Kuper-Hommel, M. ; Tsang, R. ; Pruneri, G. ; Yuen, K. ; Roos, D. ; Lennard, A. ; Devizzi, L. ; Crabb, S. ; Hossfeld, D. ; Pratt, G. ; Dell'Olio, M. ; Choo, S. P. ; Bociek, Robert G ; Radford, J. ; Lade, S. ; Gianni, A. M. ; Zucca, E. ; Cavalli, F. ; Seymour, J. F. / Primary diffuse large B-cell lymphoma of the breast : Prognostic factors and outcomes of a study by the international extranodal lymphoma study group. In: Annals of Oncology. 2008 ; Vol. 19, No. 2. pp. 233-241.
@article{acfaa5faa91541199d79d962021594f2,
title = "Primary diffuse large B-cell lymphoma of the breast: Prognostic factors and outcomes of a study by the international extranodal lymphoma study group",
abstract = "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.",
keywords = "Anthracycline-based chemotherapy, Breast, Large B-cell lymphoma, Radiotherapy",
author = "Gail Ryan and G. Martinelli and M. Kuper-Hommel and R. Tsang and G. Pruneri and K. Yuen and D. Roos and A. Lennard and L. Devizzi and S. Crabb and D. Hossfeld and G. Pratt and M. Dell'Olio and Choo, {S. P.} and Bociek, {Robert G} and J. Radford and S. Lade and Gianni, {A. M.} and E. Zucca and F. Cavalli and Seymour, {J. F.}",
year = "2008",
month = "2",
day = "1",
doi = "10.1093/annonc/mdm471",
language = "English (US)",
volume = "19",
pages = "233--241",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "2",

}

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, Robert G

AU - Radford, J.

AU - Lade, S.

AU - Gianni, A. M.

AU - Zucca, E.

AU - Cavalli, F.

AU - Seymour, J. F.

PY - 2008/2/1

Y1 - 2008/2/1

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

UR - http://www.scopus.com/inward/record.url?scp=38849086608&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=38849086608&partnerID=8YFLogxK

U2 - 10.1093/annonc/mdm471

DO - 10.1093/annonc/mdm471

M3 - Article

C2 - 17932394

AN - SCOPUS:38849086608

VL - 19

SP - 233

EP - 241

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 2

ER -