Case Series Of Primary Breast Diffuse Large B-Cll Lymphoma In Ampang Hospital, Malaysia

Abstract Abstract 5113 INTRODUCTION Breast is a rare extranodal site of non-Hodgkin's lymphoma. Traditionally, primary breast lymphoma (PBL) is defined as disease localized to one or both breasts with or without regional lymph nodes involvement (ipsilateral axillary and/or supraclavicular lymph nodes). Recently, there is a suggestion to define breast lymphoma by the number of involved extranodal disease. The commonest histology of PBL is diffuse large B-cell lymphoma (DLBCL). Treatment with CHOP-like regime (cyclophosphamide, doxorubicin, vincristine and prednisolone) in PBL-DLBCL remains unsatisfactory with 5-year progressive free survival rates of approximately 50–65%, which is generally worse than the localized nodal or other extranodal disease. The reason to the poorer outcome might be explained by the genotype. About 80% of the PBL-DLBCL is non-germinal center B-cell or activated B-cell (ABC) subtype, a poorer prognostic genotype compared to germinal center B-cell (GCB) subtype. The data of rituximab (R) overcoming genotypic effect of PBL-DLBCL is still inconclusive. However, the recent matched pair analysis showed similar 3-year overall survival rate to nodal DLBCL if using rituximab and CHOP. Immunoblast morphology appeared to be one of the prognostic factors besides the bulkiness of the disease and the high proliferation index (PI). We present our case series of DLBCL who presented with primary breast swelling from 2009 till June 2012. METHOD All the DLBCL cases diagnosed from 1st January 2009 till 30th June 2012 were filtered for breast involvement from database. Only cases presented with primary breast swelling and biopsy-proved DLBCL breast lesion were studied. Six cases were identified. All are female. CONCLUSION Looking at the six cases of primary breast DLBCL, the outcome is poor despite rituximab based chemotherapy. Better chemotherapy regime other than CHOP and agent like bortezomib and upfront autologous HSCT should be explored. Disclosures: No relevant conflicts of interest to declare.