All About Breast Lymphoma: A Rare Form of Non-Hodgkin’s Lymphoma

Breast lymphoma is a type of NHL. It develops in the lymph tissue in the breast. There’s not much lymph tissue in the breasts, which may help explain why it’s so rare. There are two types of breast lymphoma:

• Primary breast lymphoma (PBL): This is when lymphoma is found in the breast but there’s no evidence of lymphoma anywhere else.
• Secondary breast lymphoma (SBL): This is when lymphoma spreads to the breast from somewhere else. It’s rather uncommon for other cancers to spread to the breasts. Lymphoma is the most common type of cancer to do this, representing 17% of secondary breast metastases.

The most common symptom is a lump, which is typically painless. This occurs in approximately 61% of cases.

Other common symptoms are:

• swollen lymph nodes (occurs in approximately of cases)
• breast pain (occurs in approximately 12% of cases)
• local inflammation (occurs in approximately 11% of cases)
• dimpled skin that resembles an orange peel
• new asymmetry of the breasts

Involvement of both breasts occurs in about 10% of cases. This is usually associated with SBL. Other symptoms common to SBL, but not PBL, are:

• fever
• night sweats
• weight loss

Early on, breast lymphoma may not cause any symptoms at all. About 10% of the time there’s no lump and it’s an incidental finding on a routine mammogram.

Symptoms such as inflammation and breast asymmetry can mimic inflammatory breast cancer, a rare and aggressive type of breast cancer.

Visit a doctor if you have any concerning breast changes

Most clinical breast changes in women are benign. But it’s still a good idea to visit a healthcare professional for diagnosis and treatment. Other signs that you might want to see a doctor are:

• One or both breasts appear inflamed.
• The skin is dimpling.
• You have breast pain.
• You have swollen lymph nodes.

It’s not clear what causes PBL. SBL is the result of lymphoma spreading from another part of the body. We do know that it’s almost exclusively diagnosed in females, though it has been reported in males.

The median age at diagnosis is 60 to 65 years for PBL and 60 to 70 years for SBL.

Breast lumps due to breast lymphoma are similar to those of breast cancer. When you have a breast lump, diagnostic testing will likely begin with imaging tests, such as a mammogram or ultrasound. But it may not be possible to differentiate between these two conditions since the images can be so similar.

A breast biopsy is a procedure in which a doctor takes a small sample of breast tissue so it can be examined under a microscope. It’s the only sure way to determine whether the lump is due to breast cancer or breast lymphoma. Biopsy is considered the “gold standard” in establishing the diagnosis.

The diagnosis will likely be primary breast lymphoma if:

• You didn’t already have a diagnosis of lymphoma.
• There’s no evidence of lymphoma in other parts of your body.

Both PBL and SBL are cancers of the lymphatic system, so both require systemic treatment. Because it’s so rare, there are no standardized guidelines, but treatment will likely include a combination of:

• surgical removal of the lump or lumps (lumpectomy)
• chemotherapy
• radiation therapy, also known as radiotherapy

Depending on factors such as the specific type of NHL, stage, and grade, other treatments may include:

• immunotherapy
• targeted drug therapy

Mastectomy is not associated with improvement in survival or recurrence risk in breast lymphoma. Some research suggests it may actually result in higher mortality and a poorer prognosis, especially when it delays chemotherapy.

The rate of complete remission is around 64% but may be higher for those who have surgery and chemotherapy. Systemic relapse is more common than local relapse, typically occurring within 2 years. The size of the tumor is not associated with outlook.

A research article published in 2017 looked back at PBL in the U.S. from 1975 to 2013. The researchers found significant improvement in survival over that time. The 5-year relative survival rate was 90% for those diagnosed between 2005 and 2012. Survival rates were a bit lower when both breasts were involved.

Secondary breast lymphoma is already advanced at diagnosis, so the outlook is generally not as good as it is for primary breast lymphoma. Breast lymphoma is rare and so are predictive models for prognosis.

Your own outlook depends on factors such as:

• the specific type of lymphoma
• stage at diagnosis
• grade
• treatment choices
• age and overall health

Your provider can go over your medical history and offer a better understanding of your personal outlook.

Breast lymphoma is not breast cancer. It’s a rare type of NHL, a cancer of the lymphatic system. When lymphoma is found in the breast but nowhere else, it’s called primary breast lymphoma. When lymphoma spreads from other parts of the body to the breast, it’s called secondary breast lymphoma.

Signs and symptoms of breast lymphoma can be similar to those of breast cancer. It can also be hard to tell the difference on imaging tests. The only way to confirm breast lymphoma is to perform a breast biopsy.

Treatment usually involves surgery, chemotherapy, and radiation, but not a mastectomy. Breast lymphoma is treatable, especially when diagnosed in early stages.

If you develop a breast lump or other symptoms, it’s a good idea to see a doctor and find out what’s going on.