Primary Breast Diffuse Large B-Cell Lymphoma in a Young Lactating Mother Initially Treated as Breast Abscess: A Case Report
Rupesh Roshan1*, Bandana Shah2, Mukesh Yadav3, Shama Pandey4, Anuj KC5, Deepak Singh Mouni6
1Consultant Breast Oncosurgeon, Sushil Koirala Prakar Cancer Hospital, Khajura, Nepal. https://orcid.org/0009-0003-3900-6282
2Consultant Pathologist, Nepalgunj Medical College, Kohalpur, Nepal.
3Consultant Radiation Oncologist, Sushil Koirala Prakar Cancer Hospital, Khajura, Nepal.
4Consultant Medical Oncologist, National Academy of Medical Science, Kathmandu, Nepal.
5Consultant Medical Oncologist, Chitwan Medicial College, Bharatpur, Nepal. 6Consultant Breast Surgeon, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal.
*Corresponding Author: Rupesh Roshan, Consultant Breast Oncosurgeon, Sushil Koirala Prakar Cancer Hospital, Khajura, Nepal. https://orcid.org/0009 0003-3900-6282
https://doi.org/10.58624/SVOAMR.2026.04.003
Received: December 20, 2025
Published: January 29, 2026
Citation: Roshan R, Shah B, Yadav M, Pandey S, Anuj KC, Mouni DS. Primary Breast Diffuse Large B-Cell Lymphoma in a Young Lactating Mother Initially Treated as Breast Abscess: A Case Report. SVOA Medical Research 2026, 4:1, 15-20. doi: 10.58624/SVOAMR.2026.04.003
Abstract
Background: Primary breast lymphoma (PBL) is a rare extranodal manifestation of non-Hodgkin’s lymphoma, accounting for 0.4–0.5% of breast malignancies. It often mimics benign conditions like mastitis or abscess, a diagnostic pitfall heightened in lactating women due to physiological breast changes.
Case Presentation: We report the case of an 18-year-old lactating woman with a six-month history of a progressively enlarging left breast mass, initially treated as an abscess with incision and drainage without improvement. Examination revealed a large left breast mass (15x14 cm) with matted axillary and supraclavicular lymphadenopathy. Contrast-enhanced CT showed a 10x9x9 cm necrotic, infiltrative mass. Ultrasound-guided tru-cut biopsy and immunohistochemistry confirmed Diffuse Large B-Cell Lymphoma (DLBCL), Activated B-Cell (ABC) subtype with a double-expressor phenotype (C-MYC and BCL-2 positive). The patient received six cycles of R-CHOP chemotherapy followed by oncoplastic surgery (modified Benelli technique) for a residual lump, achieving a complete pathological response (ypT0).
Conclusion: This case underscores that a non-resolving breast abscess in a lactating woman warrants investigation for primary breast lymphoma. Early diagnosis via core biopsy and timely systemic chemotherapy are crucial for managing this aggressive malignancy, with surgery reserved for residual disease.
Keywords: Primary breast lymphoma, Diffuse large B-cell lymphoma, Lactating mother, Breast abscess, R-CHOP, Oncoplastic surgery