tubular carcinoma of the breast
Tubular carcinoma of the breast is a subtype of invasive ductal carcinoma (IDC).
Epidemiology
These account for ~1% of breast cancers. The peak age at presentation may be comparatively younger than with other types of breast cancer .
Clinical presentation
The vast majority of tubular carcinomas are nonpalpable and are invariably almost always found incidentally at screening rather than manifesting with clinical findings.
Pathology
Although tubular carcinoma may contain other histologic elements, an excess of 75% tubular elements is usually required for the diagnosis of tubular carcinoma . 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 .
Variants
- tubulolobular carcinoma: is an invasive lobular carcinoma (ILC) with features of tubular carcinoma but behaves as other ILCs with regard to prognosis
Associations
- ductal carcinoma in situ (DCIS): can be an association in more than 50-65 % of tubular carcinomas
Radiographic features
Mammography
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.
Breast ultrasound
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.
Breast MRI
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 .
Treatment and prognosis
The prognosis is, usually, excellent with survival of 97% at 10 years. The pure tubular forms carry the best prognosis.
Differential diagnosis
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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Assoziationen und Differentialdiagnosen zu tubular carcinoma of breast:
