Vol 17, No 4 (2021)
Review paper
Published online: 2021-05-05

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Primary breast lymphoma (PBL) in men — a systematic review

Bita Eslami1, Sadaf Alipour12, Mastoureh Mohammadipour3, Ramesh Omranipour14
DOI: 10.5603/OCP.2021.0017
Oncol Clin Pract 2021;17(4):169-175.


Primary breast lymphoma (PBL) is a rare type of lymphoma, especially in men. Details of the clinical course are not well recognized, and a consensus on the treatment of PBL in male is not available. The objective of presenting this study was to find the most common presentation and the best treatment options for male PBL by collecting and analysing data of all reported cases published between 1985 and 2019.

A comprehensive search in Google Scholar, Ovid Medline, PubMed, and Scopus databases for any case of PBL presenting in men between 1985 and 2019 was performed. Patient information such as age, diagnosis, type of treatment(s), time to follow-up and patient status were recorded.

A total of 28 studies containing data of 34 male patients with PBL were included in this review. The mean age of patients was about 61 (range: 26–85) years. The mean tumour size was 46.05 ± 20.37 mm. The majority of cases were presented with a palpable breast mass (unilateral or bilateral). Nine patients (26.5%) had previous comorbidities. Diffuse large B cell lymphoma was the most common histologic diagnosis (85.3%). Treatment consisting of systematic therapy combined with radiotherapy showed benefit outcome.

The results of the analysis showed that the response to different therapies was better in younger patients with PBL. It seems that systemic therapy combined with at least a 30 Gy dose of radiation has the best outcome in male patients with PBL. Considering limited data in each group of treatment modality, further follow-up studies in these patients are necessary.

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  1. Hugh JC, Jackson FI, Hanson J, et al. Primary breast lymphoma. An immunohistologic study of 20 new cases. Cancer. 1990; 66(12): 2602–2611, doi: 10.1002/1097-0142(19901215)66:12<2602::aid-cncr2820661224>3.0.co;2-u.
  2. Zhang Na, Cao C, Zhu Y, et al. Primary breast lymphoma: A single center study. Oncol Lett. 2017; 13(2): 1014–1018.
  3. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer. 1972; 29(1): 252–260, doi: 10.1002/1097-0142(197201)29:1<252::aid-cncr2820290138>3.0.co;2-#.
  4. Wiseman C, Liao KT. Primary lymphoma of the breast. Cancer. 1972; 29(6): 1705–1712, doi: 10.1002/1097-0142(197206)29:6<1705::aid-cncr2820290640>3.0.co;2-i.
  5. Caon J, Wai ES, Hart J, et al. Treatment and outcomes of primary breast lymphoma. Clin Breast Cancer. 2012; 12(6): 412–419.
  6. Ryan G, Martinelli G, Kuper-Hommel M, et al. International Extranodal Lymphoma Study Group. Primary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group. Ann Oncol. 2008; 19(2): 233–241.
  7. Radkani P, Joshi D, Paramo JC, et al. Primary breast lymphoma: 30 years of experience with diagnosis and treatment at a single medical center. JAMA Surg. 2014; 149(1): 91–93.
  8. Tokuyama K, Uemoto Y, Kitagawa S, et al. Primary breast diffuse large B-cell lymphoma in a male. Rinsho Ketsueki. 2017; 58(5): 455–457.
  9. Goto M, Kitamura N, Tanaka A, et al. [Primary breast diffuse large B-cell lymphoma developing subsequent to estramustine therapy for prostate cancer]. Rinsho Ketsueki. 2017; 58(12): 2411–2413.
  10. Ishibashi N, Hata M, Mochizuki T, et al. Radiation therapy for primary breast lymphoma in male gynecomastia: a rare case report and review of the literature. Int J Hematol. 2016; 104(4): 519–524.
  11. Yim B, Park J, Koo H, et al. Primary Breast Lymphoma in an Immunocompromised Male Patient: A Case Report. J Korean Soc Radiol. 2015; 73(4): 264.
  12. Cheah CY, Campbell BA, Seymour JF. Primary breast lymphoma. Cancer Treat Rev. 2014; 40(8): 900–908.
  13. Vannata B, Zucca E. Primary extranodal B-cell lymphoma: current concepts and treatment strategies. Chin Clin Oncol. 2015; 4(1): 10.
  14. Martinelli G, Ryan G, Seymour JF, et al. Primary follicular and marginal-zone lymphoma of the breast: clinical features, prognostic factors and outcome: a study by the International Extranodal Lymphoma Study Group. Ann Oncol. 2009; 20(12): 1993–1999.
  15. Hosein PJ, Maragulia JC, Salzberg MP, et al. A multicentre study of primary breast diffuse large B-cell lymphoma in the rituximab era. Br J Haematol. 2014; 165(3): 358–363.
  16. Uesato M, Miyazawa Y, Gunji Y, et al. Primary non-Hodgkin's lymphoma of the breast: report of a case with special reference to 380 cases in the Japanese literature. Breast Cancer. 2005; 12(2): 154–158.
  17. Lu H, Zhou Y. EP37.04: Sonographic findings and clinicopathological characteristics of primary breast lymphoma. Ultrasound in Obstetrics & Gynecology. 2019; 54(S1): 460–461.
  18. Pedersen C, Barton SE, Chiesi A, et al. HIV-related non-Hodgkin's lymphoma among European AIDS patients. AIDS in Europe Study Group. AIDS in Europe Study Group. Eur J Haematol. 1995; 55(4): 245–250.
  19. Teras LR, Patel AV, Hildebrand JS, et al. Postmenopausal unopposed estrogen and estrogen plus progestin use and risk of non-Hodgkin lymphoma in the American Cancer Society Cancer Prevention Study-II Cohort. Leuk Lymphoma. 2013; 54(4): 720–725.
  20. Primary Non-Hodgkin's Lymphoma of the Male Breast: A Case Report. Breast Cancer. 1999; 6(1): 55–58.
  21. Vitolo U, Seymour JF, Martelli M, et al. ESMO Guidelines Committee. Extranodal diffuse large B-cell lymphoma (DLBCL) and primary mediastinal B-cell lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016; 27(suppl 5): v91–v9v102.
  22. Avilés A, Delgado S, Nambo MJ, et al. Primary breast lymphoma: results of a controlled clinical trial. Oncology. 2005; 69(3): 256–260.
  23. Yahalom J, Illidge T, Specht L, et al. Modern Radiation Therapy for Extranodal Lymphomas: Field and Dose Guidelines From the International Lymphoma Radiation Oncology Group. Int J Radiat Oncol Biol Phys. 2015; 92(1): 11–31.
  24. López-Rodríguez E, Bujan-Lloret C, Álvarez-Pérez RM, et al. Primary breast lymphoma in a male patient. Hematol Transfus Cell Ther. 2019; 41(4): 369–370.
  25. Corobea AB, Dumitru A, Sajin M, et al. Diffuse Large B Cell Lymphoma in a Male Breast - A Rare Case Report. Chirurgia (Bucur). 2017; 112(4): 477–481.
  26. Alhabshi SM, Ismail Z, Arasaratnam SA. Primary non-Hodgkin B cell lymphoma in a man. Iran J Radiol. 2011; 8(1): 39–41.
  27. Miura Y, Nishizawa M, Kaneko H, et al. A male with primary breast lymphoma. Am J Hematol. 2009; 84(3): 191–192.
  28. Cabras MG, Amichetti M, Nagliati M, et al. Primary non-Hodgkin's lymphoma of the breast: a report of 11 cases. Haematologica. 2004; 89(12): 1527–1528.
  29. Bozkaya Y, Oz Puyan F, Bimboga B. Primary bilateral breast lymphoma in an elder male patient. Breast J. 2019; 25(5): 1008–1009.
  30. Jonckheere S, Depypere H, Standaert C. Breast Lymphoma: Teaching point: Primary breast lymphoma is a rare disease, especially in males, but should be considered in the differential diagnosis of a breast mass because of the different treatment and prognosis. J Belg Soc Radiol. 2019; 103(1): 26.
  31. Jung SP, Han KM, Kim SJ, et al. Primary follicular lymphoma in a male breast: a case report. Cancer Res Treat. 2014; 46(1): 104–107.
  32. Lokesh Kn, Sathyanarayanan V, Lakshmaiah Kc, et al. Primary breast lymphoma in males-a report of two cases with a review of the literature. Ecancermedicalscience. 2013; 7: 347.
  33. Mukhtar R, Mateen A, Rakha A, et al. Breast lymphoma presenting as gynecomastia in male patient. Breast J. 2013; 19(4): 439–440.
  34. Mouna B, Saber B, Tijani ElH, et al. Primary malignant non-Hodgkin's lymphoma of the breast: a study of seven cases and literature review. World J Surg Oncol. 2012; 10: 151.
  35. Ko ES, Seol H, Shin JH, et al. Primary anaplastic lymphoma kinase-negative anaplastic large-cell lymphoma of the breast in a male patient. Br J Radiol. 2012; 85(1012): e79–e82.
  36. Rastogi M, Revannasiddaiah S, Seam RK, et al. Extranodal lymphoma masquerading as carcinoma of the breast in an HIV-positive male patient. BMJ Case Rep. 2012; 2012.
  37. Li D, Deng J, He H, et al. Primary breast diffuse large B-cell lymphoma shows an activated B-cell-like phenotype. Ann Diagn Pathol. 2012; 16(5): 335–343.
  38. Rathod J, Taori K, Disawal A, et al. A rare case of male primary breast lymphoma. J Breast Cancer. 2011; 14(4): 333–336.
  39. Duman BB, Sahin B, Güvenç B, et al. Lymphoma of the breast in a male patient. Med Oncol. 2011; 28 Suppl 1: S490–S493.
  40. Mahmood S, Sabih Z, Sabih D. Lymphoma presenting as gynaecomastia. Biomed Imaging Interv J. 2011; 7(2): e10.
  41. Gualco G, Bacchi CE. B-cell and T-cell lymphomas of the breast: clinical--pathological features of 53 cases. Int J Surg Pathol. 2008; 16(4): 407–413.
  42. Mpallas G, Simatos G, Tasidou A, et al. Primary breast lymphoma in a male patient. Breast. 2004; 13(5): 436–438.
  43. Evans DL, Pantanowitz L, Dezube BJ, et al. Breast enlargement in 13 men who were seropositive for human immunodeficiency virus. Clin Infect Dis. 2002; 35(9): 1113–1119.
  44. Primary Non-Hodgkin's Lymphoma of the Breast: A Report of Two Cases. Breast Cancer. 1998; 5(3): 309–312.
  45. Murata T, Kuroda H, Nakahama T, et al. Primary non-Hodgkin malignant lymphoma of the male breast. Jpn J Clin Oncol. 1996; 26(4): 243–247.