Tubular Carcinoma of the Breast: a Retrospective Analysis and Review of the Literature

Department of Radiation Oncology, Harvard Medical School, Boston, MA 02114, USA.
Breast Cancer Research and Treatment (Impact Factor: 3.94). 11/2005; 93(3):199-205. DOI: 10.1007/s10549-005-5089-7
Source: PubMed


The favorable prognosis associated with tubular carcinoma of the breast has led some studies to propose less aggressive treatments for patients with this disease. This study aims to address the extent of therapy needed for tubular patients.
A retrospective review identified 73 cases of tubular carcinoma treated at the Massachusetts General Hospital between 1980 and 2002. Primary treatment was conservative surgery (CS) plus radiation therapy (RT) in 67%, CS without RT in 18%, and mastectomy in 15%. Median follow-up time was 90.5 months. The published literature of 529 conservatively treated tubular carcinomas was reviewed along with the 62 conservative cases from this series. : No patients developed distant metastasis or died from this disease. Local failure occurred in three (4%) of the cases, after 13, 84 and 121 months. All three had initially been treated with CS + RT. Five cases were node-positive, three of which were associated with a primary tumor smaller than 1 cm. Thirteen women, with a median age of 74, were treated by CS without RT and none recurred. A literature review showed that adjuvant RT reduces local failure following CS for tubular carcinoma.
Tubular carcinoma is associated with an excellent prognosis, but long-term follow-up is essential for detecting local failures and a small primary tumor size does not preclude nodal involvement. Adjuvant RT reduces the incidence of local failure following CS for tubular carcinoma, however, elderly women treated by CS may have a very low risk of local recurrence without adjuvant RT.

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    • "Tubular carcinoma (TC) of the breast is an uncommon histological subtype of invasive breast cancer that accounts for approximately 1% to 5% of invasive breast carcinomas [1-3]. TC is defined as a well-differentiated invasive carcinoma with regular cells arranged in well-defined tubules (typically one layer thick) surrounded by an abundant fibrohyaline stroma, classified as pure TC or mixed TC [1-3]. The term pure TC is assigned to tumors with a tubular composition of ≥90%, a low nuclear grade, and no mitoses [4], whereas mixed TC has a tubular composition of ≥75% [5,6]. "
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