1
|
Peng F, Li J, Mu S, Cai L, Fan F, Qin Y, Ai L, Hu Y. Epidemiological features of primary breast lymphoma patients and development of a nomogram to predict survival. Breast 2021; 57:49-61. [PMID: 33774459 PMCID: PMC8027901 DOI: 10.1016/j.breast.2021.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Studies on the epidemiology and prognosis of primary breast lymphoma (PBL) are lack for low incidence. Therefore, we aimed to investigate the epidemiological characteristics of PBL and develop nomograms to predict patient survival. METHODS Data of patients who were diagnosed with PBL from 1975 to 2011 and incidence rate of PBL from 1975 to 2017 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Time-varying multivariable Cox regression analysis was performed to identify independent prognostic factors for overall survival (OS) and disease-specific survival (DSS). Nomograms were constructed based on the independent prognostic factors identified in multivariate Cox regression analysis. RESULTS A total of 1427 patients diagnosed with PBL were identified with the average age of 67.1 years. The overall incidence of PBL is 1.35/1,000,000 (adjusted to the United States standard population in 2000) from 1975 to 2017, with a significant upward trend by an annual percentage change (APC) of 2.91 (95%CI 2.29-3.94, P < 0.05). Age, sex, race, year of diagnosis, marital status, histological subtype, Ann Arbor Stage, and treatment modality were assessed as independent prognostic factors for OS and DSS by multivariable Cox regression (P < 0.05). Nomograms were constructed to predict the 1-, 3-, 5-, and 10- year OS and DSS. The concordance index (C-index) and calibration plots showed robustness and accuracy of the nomogram. CONCLUSION The overall incidence of PBL was steadily increasing over the past four decades. Nomograms constructed can predicting 1-, 3-, 5-, and 10-year OS and identify patients with high-risk PBL.
Collapse
Affiliation(s)
- Fei Peng
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jingwen Li
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shidai Mu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Li Cai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Fengjuan Fan
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - You Qin
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Lisha Ai
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology, Wuhan, 430022, China.
| |
Collapse
|
2
|
Yu G, Ji H, Meng C, Huang Y, Gao G, Liu C, Wang S, Zhang L, Ju J. Surgical management of organizing pneumonia: a retrospective study of 24 cases in a single Centre. J Cardiothorac Surg 2019; 14:122. [PMID: 31253173 PMCID: PMC6599375 DOI: 10.1186/s13019-019-0939-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 06/17/2019] [Indexed: 11/29/2022] Open
Abstract
Background Organizing pneumonia (OP) is a rare disease that is often easily misdiagnosed as a malignancy. The diagnosis of OP can prove quite challenging. Patients typically receive treatment with high-dose corticosteroids. Relapse is common if corticosteroid treatment is reduced or stopped. However, given that long-term corticosteroid treatment often results in significant side-effects, the aim of this study was to discuss the diagnosis and surgical treatment of OP. Material and methods The medical records of 24 patients with pathologically diagnosed OP between October 2007 and January 2019 were retrospectively reviewed. All patients underwent thoracic computed tomography (CT) and transbronchial biopsy or CT-guided percutaneous needle aspiration. We analysed the clinical manifestations, radiological findings, diagnostic methods, treatment, and follow-up outcomes of all patients. Results In total, 24 patients with OP were identified. The study included 17 (70.8%) men and 7 (29.2%) women, and the mean age was 61.25 ± 11.33 years (range: 31–82). The most common symptom was cough (n = 16; 66.6%), and the most common radiological finding was consolidation (n = 13; 54.2%) on thoracic CT. The diagnosis of OP was made by transbronchial biopsy in 11 patients (45.8%), and percutaneous needle aspiration biopsy in 13 (54.2%). We performed 11 wedge resections, 9 segmentectomy, and 4 lobectomies. Twenty patients underwent video-assisted thoracoscopic surgery (VATS), and 4 underwent thoracotomy. Complete lesion resection was obtained in all patients, and all patients were discharged from the hospital between 5 and 11 days after surgery. The mean follow-up period was 59.1 ± 34.5 (range: 2–134) months. Residual lesions or local or distant recurrence were not observed. Conclusions OP is a rare disease, and the exact aetiology remains unclear. Preoperative diagnosis is difficult to achieve despite the use of transbronchial biopsy or CT-guided percutaneous needle aspiration. Complete surgical resection represents an effective method for the treatment of OP.
Collapse
Affiliation(s)
- Ge Yu
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Huaijun Ji
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China.
| | - Chuizheng Meng
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Yixuan Huang
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Guogang Gao
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Chuanping Liu
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Shanlei Wang
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Lei Zhang
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China
| | - Jin Ju
- Department of Thoracic Surgery, Weihai Municipal Hospital, 70 Heping Road, Weihai, 264200, Shandong, China.
| |
Collapse
|
3
|
Demoor-Goldschmidt C, Mahé MA, Supiot S. Breast lymphoma occurring after an invasive ductal breast carcinoma developed in the same area: A case report and literature review. Cancer Radiother 2018; 22:167-170. [PMID: 29657120 DOI: 10.1016/j.canrad.2017.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 11/09/2017] [Accepted: 11/15/2017] [Indexed: 10/17/2022]
Abstract
Chemo- and radiotherapy are treatments very helpful to cure cancers but are also well known for adverse effects such as secondary cancers. Breast cancers following Hodgkin lymphoma have been relatively well studied. Breast cancers after radiotherapy covering or nearby breasts or nipples are usually carcinomas or secondary sarcomas. Among the big cohort of patients treated for breast carcinomas, breast lymphomas developed in the same area are not usual. Nevertheless, published studies described a significant increased risk of non-Hodgkin lymphoma after initial radiotherapy for a solid cancer. Here, we report a case of a secondary breast lymphoma observed in a 53-year-old woman treated 13 years before for a ductal carcinoma and analyse such second tumors with a review of the literature. This case report emphasizes the importance of the biopsy in case of recurrence in breast cancer to give the appropriate treatment.
Collapse
Affiliation(s)
- C Demoor-Goldschmidt
- Integrated Center of Oncology, Institut de cancérologie de l'Ouest-René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France; Faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France; Inserm UMR 1018, centre de recherche en épidémiologie et santé des populations, 114, rue Édouard-Vaillant, 94805 Villejuif, France; Institut Gustave-Roussy, B2M, 114, rue Édouard-Vaillant, 94805 Villejuif, France.
| | - M-A Mahé
- Integrated Center of Oncology, Institut de cancérologie de l'Ouest-René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France; Faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France; Inserm UMR892, 8, quai Moncousu, 44007 Nantes, France
| | - S Supiot
- Integrated Center of Oncology, Institut de cancérologie de l'Ouest-René-Gauducheau, boulevard Jacques-Monod, 44800 Saint-Herblain, France; Faculté de médecine, université de Nantes, 1, rue Gaston-Veil, 44000 Nantes, France; Inserm UMR892, 8, quai Moncousu, 44007 Nantes, France
| |
Collapse
|
4
|
Jabbour G, El-Mabrok G, Al-Thani H, El-Menyar A, Al Hijji I, Napaki S. Primary Breast Lymphoma in a Woman: A Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2016; 17:97-103. [PMID: 26893404 PMCID: PMC4763798 DOI: 10.12659/ajcr.896264] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Patient: Female, 43 Final Diagnosis: Primary breast lymphoma Symptoms: — Medication: — Clinical Procedure: CT scan • PET • chemotherapy • radiotherapy Specialty: Oncology
Collapse
Affiliation(s)
- Gaby Jabbour
- Department of Surgery, General Surgery, Hamad General Hospital, Doha, Qatar
| | - Gamela El-Mabrok
- Department of Surgery, General Surgery, Hamad General Hospital, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, General Surgery, Hamad General Hospital, Doha, Qatar
| | - Ayman El-Menyar
- Department of Surgery, Clinical Research, Hamad General Hospital, Doha, Qatar
| | | | - Sarbar Napaki
- Department of Laboratory Medicine and Pathology, Hamad General Hospital, Doha, Qatar
| |
Collapse
|
5
|
Epler GR, Kelly EM. Systematic review of postradiotherapy bronchiolitis obliterans organizing pneumonia in women with breast cancer. Oncologist 2014; 19:1216-26. [PMID: 25361622 DOI: 10.1634/theoncologist.2014-0041] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Radiation therapy for breast cancer has been implicated in the development of bronchiolitis obliterans organizing pneumonia (BOOP). This inflammatory lung disorder was first noted in 1983, and there have been numerous reports of BOOP occurring in women who have had radiation therapy for breast cancer since 1995. This study was undertaken to perform a systematic review of postradiotherapy BOOP to determine the occurrence, presentation, treatment, and outcome. MATERIALS AND METHODS A systematic literature review was conducted according to the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses report. RESULTS The literature search yielded 10 Japanese epidemiological reports with 129 women, 4 case series reports with 36 women, and 24 case reports with 34 women. Common symptoms included fever, cough, and shortness of breath. Most patients received corticosteroid therapy, and duration of treatment ranged from 6 months to 1 year, although some patients received steroids for longer than 1 year because of relapse, which occurred in approximately one half of patients. No deaths have been reported. CONCLUSION BOOP is a rare but significant complication from radiation therapy for breast cancer. Chest radiographic studies for women who report new respiratory symptoms during the postradiation period can be beneficial for early diagnosis and for guiding appropriate management.
Collapse
Affiliation(s)
- Gary R Epler
- Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Kelly Research and Consulting, Smithtown, New York, USA
| | - Eileen M Kelly
- Pulmonary and Critical Care Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA; Kelly Research and Consulting, Smithtown, New York, USA
| |
Collapse
|
6
|
Caon J, Wai ES, Hart J, Alexander C, Truong PT, Sehn LH, Connors JM. Treatment and Outcomes of Primary Breast Lymphoma. Clin Breast Cancer 2012; 12:412-9. [PMID: 23018097 DOI: 10.1016/j.clbc.2012.07.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 05/10/2012] [Accepted: 07/09/2012] [Indexed: 10/27/2022]
|
7
|
Secondary hematological malignancies following breast cancer treatment. Oncol Rev 2010. [DOI: 10.1007/s12156-010-0037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
8
|
Romero-Guadarrama MB, Hernández-González MM, Durán-Padilla MA, Rivas-Vera S. Primary lymphomas of the breast: a report on 5 cases studied in a period of 5 years at the Hospital General de México. Ann Diagn Pathol 2009; 13:78-81. [PMID: 19302954 DOI: 10.1016/j.anndiagpath.2008.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Breast lymphomas can be primary or secondary. Among the primary lymphomas, the most common histologic types are the large B-cell diffuse lymphomas and the extranodal B mucosa-associated lymphatic tissue lymphomas. We studied 5 cases of primary breast lymphoma in female patients. The criteria for the diagnosis were based on the proposal of Wiseman and Liao: (1) in the biopsy or surgical specimen, the lymphoma involves the breast parenchyma, and (2) nonsystemic disease at diagnosis. Clinical data, histologic findings, immunohistochemical reactions, treatment, and clinical follow-up were reviewed. The 5 patients were young women with average age of 27 years; the youngest was 20 years old, and the oldest was 44 years old. The right breast was the most affected, and 1 patient was HIV positive. The most common symptoms were the presence of nodes, progressive increase of volume, collateral venous network, and hemorrhagic discharge from the nipple. The clinical course was of 1 to 14 months before diagnosis. Three patients died because of central nervous system infiltration, one is still alive, and the other was lost during follow-up. Histologically, all primary breast lymphomas were large B-cell lymphomas; one had focal starry sky pattern, and the other 3 were centroblastic. All were positive to CD20 and CD79(a), 3 expressed bcl2, and 2 expressed bcl6. The proliferation index was between 60% and 80%. Primary breast lymphomas are rare. The average age of our patients was 27 years, and their clinical course was aggressive with central nervous system infiltration. The most common histologic type was the large B-cell diffuse lymphoma. Differential diagnosis must be established in the presence of poorly differentiated lobules and ductal carcinoma.
Collapse
Affiliation(s)
- Mónica B Romero-Guadarrama
- Pathology Unit of the Hospital General de México, School of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, CP 06726, México.
| | | | | | | |
Collapse
|