Tubular carcinoma of the breast
Citation, DOI and article data
Tubular carcinoma of the breast is a subtype of invasive ductal carcinoma (IDC).
These account for ~1% of breast cancers. The peak age at presentation may be comparatively younger than with other types of breast cancer 7.
The vast majority of tubular carcinomas are non-palpable and are invariably almost always found incidentally at screening rather than manifesting with clinical findings.
Although tubular carcinoma may contain other histologic elements, an excess of 75% tubular elements is usually required for the diagnosis of tubular carcinoma 2. A distinguishing pathological feature is a single layer of cells lining tubules with loss of lobular architecture and surrounding infiltration. The glands in tubular carcinomas lack myoepithelial cells. Lesions may be multifocal or multicentric in ~15% (range 10-20%) of cases 7.
- tubulolobular carcinoma: is an invasive lobular carcinoma (ILC) with features of tubular carcinoma but behaves as other ILCs with regard to prognosis
- ductal carcinoma in situ (DCIS): can be an association in more than 50-65 % of tubular carcinomas 3,7
In the majority of cases, the lesion is very small (< 1 cm), spiculated and can occur with or without calcifications. The appearance mimics typical IDC not otherwise specified, manifesting as one or more small spiculated masses. The spicules are often longer than the central mass. Amorphous microcalcifications may be present in 10-15% of cases 6.
On an ultrasound, the appearance also mimics IDC not otherwise specified, manifesting as a hypoechoic solid mass with ill-defined margins and posterior acoustic shadowing. The lesions are often rounded tall as broad.
Dynamic subtraction MR-imaging might show characteristics of a malignant tumor and can be helpful to rule out malignancy in a non-palpable breast tumor 8.
Treatment and prognosis
The prognosis is, usually, excellent 5 with survival of 97% at 10 years. The pure tubular forms carry the best prognosis.
For mammographic appearances consider:
- 1. Harvey JA. Unusual breast cancers: useful clues to expanding the differential diagnosis. Radiology. 2007;242 (3): 683-94. doi:10.1148/radiol.2423051631 - Pubmed citation
- 2. Sheppard DG, Whitman GJ, Huynh PT et-al. Tubular carcinoma of the breast: mammographic and sonographic features. AJR Am J Roentgenol. 2000;174 (1): 253-7. AJR Am J Roentgenol (full text) - Pubmed citation
- 3. Cabral AH, Recine M, Paramo JC et-al. Tubular carcinoma of the breast: an institutional experience and review of the literature. Breast J. 9 (4): 298-301. Breast J (link) - Pubmed citation
- 4. Winchester DJ, Sahin AA, Tucker SL et-al. Tubular carcinoma of the breast. Predicting axillary nodal metastases and recurrence. Ann. Surg. 1996;223 (3): 342-7. Ann. Surg. (link) - Free text at pubmed - Pubmed citation
- 5. Sullivan T, Raad RA, Goldberg S et-al. Tubular carcinoma of the breast: a retrospective analysis and review of the literature. Breast Cancer Res. Treat. 2005;93 (3): 199-205. doi:10.1007/s10549-005-5089-7 - Pubmed citation
- 6. Conant EF, Brennecke CM. Breast imaging, case review. Mosby Inc. (2006) ISBN:0323017460. Read it at Google Books - Find it at Amazon
- 7. Cardeñosa G. Clinical breast imaging, a patient focused teaching file. Lippincott Williams & Wilkins. (2006) ISBN:0781762677. Read it at Google Books - Find it at Amazon
- 8. Eurorad teaching files : Case 1345
- 9. Paredes ES. Atlas of mammography. Lippincott Williams & Wilkins. (2007) ISBN:0781764335. Read it at Google Books - Find it at Amazon