Tubular Carcinoma of the Breast

Doctor and patient working on digital tablet
Thomas Barwick/Stone/Getty Images

What is tubular carcinoma of the breast? How does this differ from other types of breast cancer and how does this differ from tubular breasts? Let's take a look at the symptoms, diagnosis, and treatment options, as well as the prognosis of this uncommon type of breast cancer.

Tubular Carcinoma of the Breast Defined 

Tubular carcinoma is an uncommon type of invasive ductal carcinoma of the breast. It takes its name from its microscopic appearance, in which the cancer cells resemble small tubes.

Tubular carcinomas tend to be small, estrogen-receptor positive, HER2/neu negative cancers. In some cases, tubular cancer cells are mixed with ductal or lobular cancer cells, giving a mixed-tumor diagnosis.

Tubular carcinomas have accounted for roughly 2 percent of all breast cancer diagnoses, but this number is increasing, probably secondary to routine mammogram screenings. People who develop tubular carcinoma are usually 50 years of age or older.

Tubular carcinoma is also known as tubular breast cancer, TC, and tubulolobular carcinoma (TLC), when mixed with lobular carcinoma.

Difference Between Tubular Carcinoma and Tubular Breasts

Tubular breasts, or tuberous breasts, are a congenital breast condition in which the breasts don't develop as much glandular tissue as a normal mature breast. Tubular breasts may have large areolas, are very narrow at the chest wall, and grow in a drooping fashion. Plastic surgery can be done to reshape tubular breasts into a more normal shape. Having tubular breasts is a different condition than having tubular carcinoma.

Signs and Symptoms

You may not be able to feel a lump with tubular carcinoma and these cancers often show up first on a routine mammogram. If it is mixed with invasive ductal cells and has formed a more prominent lump, you might be able to feel the ductal lump. When tubular cancer cells are combined with lobular breast cancer (tubulolobar), your symptoms may resemble invasive lobular carcinoma, such as a thickened area on examination but without a discrete lump.

Diagnosis

Tubular carcinomas are often very small but may show up on a mammogram as an irregularly shaped mass with a spiky, or starry outline. On a breast ultrasound, a tubular carcinoma can show up as a mass with a fuzzy outline and may have calcifications nearby.

The center of a tubular carcinoma will be denser than the outer areas of the mass. A biopsy will be needed to obtain a tissue sample so that a pathologist can do a microscopic examination, which will give a clear diagnosis.

Treatments

t, though these may differ somewhat from other breast cancers as these tumors are less likely to spread. Options may include:

Surgery: Either a mastectomy or lumpectomy may be done to remove these tumors. Since the tumors are often small, a lumpectomy may be a good option. A sentinel node biopsy is usually done, since even small tumors (for example, 1 cm) may have lymph node involvement.

Radiation therapy: Since a lumpectomy is usually done for these tumors, radiation therapy is used after surgery to treat the remaining breast tissue.

Hormonal therapy: Since tubular carcinomas are often estrogen-receptor positive, hormonal therapy can be very effective in reducing the risk of recurrence. For premenopausal women, tamoxifen is often used. For postmenopausal women, or premenopausal women who have had their ovaries removed or ovarian suppression therapy, aromatase inhibitors are usually recommended. Treatment with these medications is usually recommended if the tumor is larger than 1 cm and/or if lymph nodes are positive.

Chemotherapy: Since these tumors are unlikely to spread to the lymph nodes, and hence to other regions of the body, it's less likely that adjuvant chemotherapy will be needed for these tumors. Chemotherapy, however, is usually recommended if more than one lymph node is positive.

Follow-Up After Treatment

Careful follow-up after treatment is needed just as with any type of breast cancer. It's not uncommon for women who have had a tubular carcinoma to develop cancer in their other breast, and therefore monitoring with mammograms and/or breast MRI is very important.

Tumor Size and Prognosis

Tubular carcinomas are usually small (1–2 cm diameter) and do not usually spread far beyond the original tumor site. It is possible, but unusual, for tubular carcinoma to travel to your lymph nodes-–and unaffected lymph nodes means less chance of metastasis. Your chance of recovery and survival after treatment for a tubular carcinoma is very good. Overall, the prognosis of tubular carcinoma is better than either ductal carcinoma or lobular carcinoma.

A Word From Verywell

Tubular carcinoma of the breast is a cancer that is usually small and often has an excellent prognosis. That said, any cancer of any stage is frightening. It's important to reach out to your friends and family. Consider joining an in-person or online support group. Learn as much as you can about your disease. With tumors that are less common, it can also be helpful to get a second opinion at one of the larger cancer centers which may have oncologists who have treated several people with this specific tumor. These tumors are usually small but also tend to spread to lymph nodes at a smaller stage than some other types of cancer. Fortunately, the majority of these tumors are estrogen receptor positive, and hormone therapy can be effective in reducing the risk of recurrence.

View Article Sources