POSTER'9'
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PRIMARY'LYMPHOMA'OF'THE'BREAST,'A'SINGLE'CENTRE'EXPERIENCE'
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Vasiliki! Babali1,! Maria! Bouzani1,! Dimitra! Ikonomopoulou1,! Chara! Giatra1,! George! Kanellis2,! Dimitra!
Rontogianni3,!Themistoklis!Karmiris1!and!Maria!Bakiri1!
!
(1)Department! of! Hematology! and! Lymphoma! U! BMT! Unit,! Evaggelismos! General! Hospital,! Athens,!
Greece,! (2)Department! of! Hematopathology,! Evaggelismos! General! Hospital,! Athens,! Greece,!
(3)Department!of!Pathology,!Evaggelismos!General!Hospital,!Athens,!Greece!
!
Background!
Primary! breast! lymphoma! (PBL)! is! a! type! of! extranodal! lymphoma,! affecting! mainly! the!
women!and!infiltrating!the!breast!with!or!without!ipsilateral!lymphnodes.!It!is!a!rare!disease,!
accounting! for! less! than! 2%! of! extranodal! lymphomas! and! is! considered! as! high! risk! for!
Central! Nervous! System! (CNS)! relapse.! Due! to! it’s! rarity! and! the! diversity! of! it’s!
histopathologic!manifestations,!there!is!no!specific!recommendations!for!it’s!treatment.!
Aim!
To!reveal!the!experience!of!our!centre!on!the!diagnosis,!treatment!and!outcome!of!this!rare!
extranodal!lymphoma!
Methods!
We! collected! data! from! 11! consecutive! patients,! diagnosed! at! our! department! with! PBL,!
between!2009!and!2020!
Results!
All! patients! were! women! with! median! age! 58! years! (range! 31J78)! and! low! International!
prognostic!Index!(IPI)!score.!In!all!cases!PBL!was!unilateral,!with!similar!distribution!on!each!
side.! In! 2! patients! there! was! involvement! of! a! regional! lymphJnode! (Ann! Arbor! stage! IIE).!
Nobody! presented! B! symptoms! at! diagnosis.! In! 63%! of! cases! lactate! dehydrogenase! was!
normal.!Interestingly,!betaJ2Jmicroglobulin!was!increased!in!7!out!of!11!cases.!Eight!patients!
manifested!aggressive!Non!Hodgkin!Lymphoma!(NHL).!Among!them,!6!showed!Diffuse!large!
B! cell! lymphoma! (DLBCL)! and! 2! demonstrated! Breast! Implant! Associated! Anaplastic! Large!
Cell!Lymphoma.!The!remaining!3!patients!revealed!indolent!marginal!zone!NHL!(MALT).!All!
patients! with! aggressive! NHL! underwent! a! lumbar! puncture! for! assessment! of! CNS!
involvement.! All! were! negative! for! CNS! infiltration.! Two! patient! underwent! capsulectomy!
and! replacement! of! prosthesis! and! six! other! lumpectomy.! All! patients! with! aggressive!
lymphoma! received! CHOPJlike! regimens,! together! with! Rituximab! for! the! DLBCLs.! Two!
patients! with! MALT! were! set! under! observation! after! lumpectomy! without! further!
treatment! and! one! case! of! MALTJPBL! received! 4! cycles! of! Rituximab! without! surgery.! All!
patients! with! aggressive! lymphoma! received! intrathecal! CNS! prophylaxis.! Nobody!
underwent!radiotherapy.!All!patients!achieved!a!complete!response.!One!patient!with!MALT!
who! was! treated! only! with! surgery,! relapsed! 15! months! later! and! she! achieved! a! 2nd! CR!
after!4!cycles!of!Rituximab!induction!and!2!years!of!Rituximab!maintenance.!With!a!median!
follow! up! of! 54.7! months! (range! 2! J! 131),! all! patients! are! alive.! The! median! disease! free!
survival!(DFS)!for!the!same!period!of!observation!is!48.3!months!(range!2!J!131).!
Conclusion!
PBL! under! combined! treatment! (surgery! +! immunochemotherapy)! demonstrates! a! very!
good!outcome.!BJ2Jmicroglobulin!could!be!a!marker!for!the!activity!of!the!disease.!
! !
SCIENTIFIC PROGRAMME
SESSION I
HODGKIN’S DISEASE
DEBATE I
IS THERE STILL A ROLE
FOR COMBINED MODALITY
THERAPY FOR EARLY
STAGE CHL?
SESSION II
T-CELL LYMPHOMA
ROUNDTABLE I
FUTURE DIRECTIONS IN
T-CELL LYMPHOMA
SESSION III
FOLLICULAR LYMPHOMA
DEBATE II
CAN WE AVOID
CHEMOTHERAPY IN
THE MANAGEMENT OF
FOLLICULAR LYMPHOMA?
SESSION IV
RARE LYMPHOMAS –
MARGINAL ZONE
LYMPHOMA AND
WALDENSTRÖM M
ACROGLOBULINEMIA
ROUNDTABLE II – WHERE
TO GO IN RARE B-CELL
LYMPHOMAS
SESSION V
MANTLE CELL LYMPHOMA
SESSION VI
DIFFUSE LARGE B-CELL
LYMPHOMA
DEBATE III
DO WE STILL NEED ASCT
IN MCL?
SESSION VII
NOVEL THER APEUTIC
CONCEPTS IN B-CELL
LYMPHOMAS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
DISCLOSURES