Clinical Features and Outcomes of Primary Breast Diffuse Large B-Cell Lymphoma: A Matched-Pair Study

Ling-Chiao Teng; Yu-Min Liao; Jyh-Pyng Gau; Tzu-Hung Hsiao; Tsung-Chih Chen; Mei-Hui Chen; Su-Peng Yeh; Chieh-Lin Jerry Teng

doi:10.1177/11795549231203142

Clinical Features and Outcomes of Primary Breast Diffuse Large B-Cell Lymphoma: A Matched-Pair Study

Clin Med Insights Oncol. 2023 Oct 28:17:11795549231203142. doi: 10.1177/11795549231203142. eCollection 2023.

Authors

Ling-Chiao Teng¹, Yu-Min Liao², Jyh-Pyng Gau³, Tzu-Hung Hsiao^{4

5

6

7}, Tsung-Chih Chen¹, Mei-Hui Chen^{1

8

9}, Su-Peng Yeh^{2

10}, Chieh-Lin Jerry Teng^{1

11

12

13

14

15}

Affiliations

¹ Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung.
² Department of Hematology and Oncology, China Medical University Hospital, Taichung.
³ Division of Hematology and Oncology, Department of Medicine, Taipei Medical University Hospital, Taipei City.
⁴ Department of Medical Research, Taichung Veterans General Hospital, Taichung.
⁵ Department of Chemical Engineering, National Tsing Hua University, Hsinchu.
⁶ Department of Public Health, Fu Jen Catholic University, New Taipei City.
⁷ Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung.
⁸ Department of Nursing, Taichung Veterans General Hospital, Taichung.
⁹ College of Nursing, Hung Kuang University, Taichung.
¹⁰ School of Medicine, China Medical University, Taichung.
¹¹ Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung.
¹² Department of Life Science, Tunghai University, Taichung.
¹³ School of Medicine, Chung Shan Medical University, Taichung.
¹⁴ Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung.
¹⁵ Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung.

Abstract

Background: The influence of the breast as the primary site on the outcome of diffuse large B-cell lymphoma (DLBCL) and further changes in therapeutic strategies remain unclear. We aimed to compare the outcomes between primary breast and non-breast DLBCL and analyze the genetic profiles of some of the study cohorts using next-generation sequencing.

Methods: This matched-pair study reviewed the medical records of 19 patients with stage I and II primary breast DLBCL diagnosed between January 2005 and December 2021 on the basis of the Wiseman and Liao criteria, and we used 1:4 propensity score matching to identify patients with non-breast DLBCL as the control group. The overall response rate, progression-free survival (PFS), and overall survival (OS) were the outcome measures.

Results: Patients with primary breast and non-breast DLBCL had a 5-year PFS of 72.6% and 86.9%, respectively (P = .206). These 2 groups also had comparable 5-year OS (86.9% vs 87.8%; P = .772). The breast as the primary site was not associated with inferior PFS (hazard ratio [HR]: 2.14; 95% CI: 0.66-6.96; P = .206) and OS (HR: 1.26; 95% CI: 0.27-5.93; P = .772).

Conclusion: Patients with primary breast DLBCL and those with non-breast DLBCL had comparable PFS and OS under rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or R-CHOP-like regimens. Further investigations of the mutation profile, its clinical impact, potential central nervous system relapse, and prognosis of primary breast DLBCL are required.

Keywords: DLBCL; NGS; OS; PFS; breast.