Supplementary Material for: Sequential Diagnosis of Metastatic Breast Cancer and Follicular Lymphoma in a Postmenopausal Woman: Navigating Endocrine and Cytotoxic Therapies in a Complex Oncologic Setting

Introduction: Dual primary malignancies involving solid and hematological tumors are rare, posing significant diagnostic and therapeutic challenges. We report here a case of concurrent breast cancer and follicular lymphoma. Case Presentation: A 52-year-old woman with hormone receptor-positive early-stage breast cancer (pT2N2a) developed pleural metastasis concurrently with newly diagnosed follicular lymphoma (Ann Arbor stage IIIA, Grade 1-2) at 3 years postdiagnosis. The lymphoma progressed during treatment for metastatic breast cancer. Consequently, treatment was switched to combination immunochemotherapy with rituximab, cyclophosphamide, vincristine, and prednisolone (R-CVP). The patient achieved a partial response for follicular lymphoma, without breast cancer progression. Endocrine therapy with letrozole and palbociclib was successfully resumed following bone marrow recovery. Conclusion: This case highlights the need to consider secondary malignancies during cancer treatment and demonstrates the clinical utility of R-CVP in the management of dual cancer.

引言：实体瘤与血液系统恶性肿瘤并存的双重原发性恶性肿瘤较为罕见，给临床诊断与治疗带来了严峻挑战。本文报告1例同时并发乳腺癌与滤泡性淋巴瘤（Follicular Lymphoma）的病例。
病例报告：一名52岁女性患者，既往确诊为激素受体阳性早期乳腺癌（pT2N2a），在确诊后3年时，同时出现胸膜转移与新诊断的滤泡性淋巴瘤（Ann Arbor分期ⅢA期，1-2级）。该淋巴瘤在患者接受转移性乳腺癌治疗期间出现进展，因此调整治疗方案为利妥昔单抗（Rituximab）联合环磷酰胺（Cyclophosphamide）、长春新碱（Vincristine）及泼尼松（Prednisolone）的免疫化疗方案（R-CVP）。患者的滤泡性淋巴瘤获得部分缓解，乳腺癌未出现进展。骨髓功能恢复后，患者成功重启来曲唑（Letrozole）联合帕博西尼（Palbociclib）的内分泌治疗。
结论：本病例提示在癌症治疗过程中需警惕继发性恶性肿瘤的发生，并证实了R-CVP方案在双重恶性肿瘤管理中的临床应用价值。