Tubular carcinoma of the breast

Last revised by Joshua Yap on 13 May 2023

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.

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 and 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.

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:

  • radial scar/complex sclerosing lesion: in practice rarely you do confuse these two lesions, the tubular carcinoma is dense centrally; the converse is true for a radial scar; both can have long "runners" or spiculation

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Cases and figures

  • Case 1a: mammogram
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  • Case 1b: ultrasound
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