Skip to main content

Advertisement

SpringerLink
Log in

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

  • Report
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Background. 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.

Methods. 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.

Results. 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.

Conclusions. 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. H Cooper A Patchefsky R Krall (1978) ArticleTitleTubular carcinoma of the breast Cancer 42 2334–2342 Occurrence Handle214219

    PubMed  Google Scholar 

  2. J Rescigno PB Schiff (1997) ArticleTitleTubular carcinoma: Analysis of 1623 patients from the SEER database (Abstr.) Breast Cancer Res. Treat 46 40

    Google Scholar 

  3. SG Diab GM Clark CK Osborne A Libby DC Allred RM Elledge (1999) ArticleTitleTumor Characteristics and Clinical Outcome of Tubular and Mucinous Breast Carcinomas J Clin Oncol 17 1442–1448 Occurrence Handle10334529

    PubMed  Google Scholar 

  4. MC Weiss BL Fowble LJ Solin IT Yeh DJ Schultz (1992) ArticleTitleOutcome of conservative therapy for invasive breast cancer by histologic subtype Int J Radiat Oncol Biol Phys 23 941–947 Occurrence Handle1322387

    PubMed  Google Scholar 

  5. HA Kader J Jackson D Mates S Andersen M Hayes IA Olivotto (2001) ArticleTitleTubular carcinoma of the breast: A population-based study of nodal metastases at presentation and of patterns of relapse Breast J 7 8–13 Occurrence Handle10.1046/j.1524-4741.2001.007001008.x Occurrence Handle11348409

    Article  PubMed  Google Scholar 

  6. SA Thurman SJ Schnitt JL Connolly R Gelman B Silver JR Harris A Recht (2004) ArticleTitleOutcome after breast-conserving therapy for patients with stage I or II mucinous, medullary, or tubular breast carcinoma Int J Radiat Oncol Biol Phys 59 159 Occurrence Handle10.1016/j.ijrobp.2003.10.029

    Article  Google Scholar 

  7. Leonard C, Chen B, Tenny C, Howell K, Jennings L, Norton L, Aarestad N, Sedlacek S. Clinical implications of axillary dissections for tubular carcinoma of the breast in a community setting (Abstr.). Proc Am Soc Clin Oncol 15, 1996

  8. AH Cabral M Recine JC Paramo MM McPhee R Poppiti TW Mesko (2003) ArticleTitleTubular carcinoma of the breast: An institutional experience and review of the literature Breast J 9 298–301 Occurrence Handle10.1046/j.1524-4741.2003.09409.x Occurrence Handle12846864

    Article  PubMed  Google Scholar 

  9. PRB Kitchen HJ Smith MA Henderson A Goldhirsch M Castiglione-Gertsch AS Coates B Gusterson RW Brown RD Gelber JP Collins (2001) ArticleTitleTubular carcinoma of the breast: Prognosis and response to adjuvant systemic therapy ANZ J Surg 71 27–31 Occurrence Handle10.1046/j.1440-1622.2001.02022.x Occurrence Handle11167594

    Article  PubMed  Google Scholar 

  10. DJ Winchester AA Sahin SL Tucker SE Singletary (1996) ArticleTitleTubular carcinoma of the breast. Predicting axillary nodal metastases and recurrence Ann Surg 223 342–347 Occurrence Handle10.1097/00000658-199603000-00015 Occurrence Handle8604915

    Article  PubMed  Google Scholar 

  11. GN Peters M Wolff CD Haagensen (1981) ArticleTitleTubular carcinoma of the breast. Clinical pathologic correlations based on 100 cases Ann Surg 193 138–149 Occurrence Handle7469549

    PubMed  Google Scholar 

  12. PH Carstens RA Greenberg D Francis H Lyon (1985) ArticleTitleTubular carcinoma of the breast. A long term follow-up Histopathology 9 271–280 Occurrence Handle2987100

    PubMed  Google Scholar 

  13. G Papadatos AM Rangan T Psarianos O Ung R Taylor J Boyages (2001) ArticleTitleProbability of axillary node involvement in patients with tubular carcinoma of the breast Br J Surg 88 860–864 Occurrence Handle10.1046/j.0007-1323.2001.01779.x Occurrence Handle11412259

    Article  PubMed  Google Scholar 

  14. Arias E: United States life tables, 2001. National vital statistics reports; vol. 52 no. 14. Hyattsville, Maryland: National Center for Health Statistics, 2004

  15. DA Fein BL Fowble AL Hanlon MA Hooks JP Hoffman ER Sigurdson LA Jardines BL Eisenberg (1997) ArticleTitleIdentification of women with T1–T2 breast cancer at low risk of positive axillary nodes J Surg Oncol 65 34–39 Occurrence Handle10.1002/(SICI)1096-9098(199705)65:1<34::AID-JSO7>3.0.CO;2-P Occurrence Handle9179265

    Article  PubMed  Google Scholar 

  16. D Krag D Weaver T Ashikaga F Moffat VS Klimberg C Shriver S Feldman R Kusminsky M Gadd J Kuhn S Harlow P Beitsch P Whitworth R Foster K Dowlatshahi (1998) ArticleTitleThe sentinel node in breast cancer – A multicenter validation study N Engl J Med 339 941–946 Occurrence Handle10.1056/NEJM199810013391401 Occurrence Handle9753708

    Article  PubMed  Google Scholar 

  17. B Fisher S Anderson J Bryant RG Margolese M Deutsch ER Fisher J-H Jeong N Wolmark (2002) ArticleTitleTwenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer N Engl J Med 347 1233–1241 Occurrence Handle10.1056/NEJMoa022152 Occurrence Handle12393820

    Article  PubMed  Google Scholar 

  18. B Fisher J Bryant JJ Dignam DL Wickerham EP Mamounas ER Fisher RG Margolese L Nesbitt S Paik TM Pisansky N Wolmark (2002) ArticleTitleTamoxifen, radiation therapy, or both for prevention of ipsilateral breast tumor recurrence after lumpectomy in women with invasive breast cancers of one centimeter or less J Clin Oncol 20 4141–4149 Occurrence Handle10.1200/JCO.2002.11.101 Occurrence Handle12377957

    Article  PubMed  Google Scholar 

  19. U Veronesi B Salvadori A Luini M Greco R Saccozzi M Vecchio Particledel L Mariani S Zurrida F Rilke (1995) ArticleTitleBreast conservation is a safe method in patients with small cancer of the breast: Long-term results of three randomized trials of 1973 patients Eur J Cancer 31A 1574–1581 Occurrence Handle10.1016/0959-8049(95)00271-J Occurrence Handle7488404

    Article  PubMed  Google Scholar 

  20. InstitutionalAuthorNameEarly Breast Cancer Trialists Collaborative Group (1995) ArticleTitleEffects of radiotherapy and surgery in early breast cancer: An overview of the randomized trials N Engl J Med 333 1444–1455

    Google Scholar 

  21. InstitutionalAuthorNameEarly Breast Cancer Trialists Collaborative Group (2000) ArticleTitleFavourable and unfavourable effects on long-term survival of radiotherapy for early breast cancer: an overview of the randomised trials Lancet 355 1757–1770

    Google Scholar 

  22. RM Clark T Whelan M Levine R Roberts A Willan P McCulloch M Lipa RH Wilkinson LJ Mahoney (1996) ArticleTitleRandomized clinical trial of breast irradiation following lumpectomy and axillary dissection for node-negative breast cancer: an update. Ontario Clinical Oncology Group J Natl Cancer Inst 88 1659–1664 Occurrence Handle8931610

    PubMed  Google Scholar 

  23. ER Fisher S Anderson E Tan-Chiu B Fisher L Eaton N Wolmark (2001) ArticleTitleFifteen-year prognostic discriminants for invasive breast carcinoma: National Surgical Adjuvant Breast and Bowel Project Protocol-06 Cancer 91 1679–1687 Occurrence Handle10.1002/1097-0142(20010415)91:8+<1679::AID-CNCR1183>3.0.CO;2-8 Occurrence Handle11309768

    Article  PubMed  Google Scholar 

  24. JH Borger H Kemperman A Hart H Peterse J Dongen Particlevan H Bartelink (1994) ArticleTitleRisk factors in breast conservation therapy J Clin Onc 12 653–660

    Google Scholar 

  25. PH Elkhuizen MJ Vijver Particlevan de J Hermans HM Zonderland CJ Velde Particlevan de JW Leer (1998) ArticleTitleLocal recurrence after breast-conserving therapy for invasive breast cancer: High incidence in young patients and association with poor survival. Int J Radiat Oncol Biol Phys 40 859–867 Occurrence Handle10.1016/S0360-3016(97)00917-6 Occurrence Handle9531371

    Article  PubMed  Google Scholar 

  26. G Liljegren A Lindgren J Bergh H Nordgren L Tabar L Holmberg (1997) ArticleTitleRisk factors for local recurrence after conservative treatment in stage I breast cancer. Definition of a subgroup not requiring radiotherapy Ann Oncol 8 235–241 Occurrence Handle10.1023/A:1008200711466 Occurrence Handle9137791

    Article  PubMed  Google Scholar 

  27. DI Benhaim R Lopchinsky PI Tartter (2000) ArticleTitleLumpectomy with tamoxifen as primary treatment for elderly women with early-stage breast cancer Am J Surg 180 162–166 Occurrence Handle10.1016/S0002-9610(00)00474-8 Occurrence Handle11084120

    Article  PubMed  Google Scholar 

  28. T Gruenberger M Gorlitzer T Soliman M Rudas M Mittlboeck M Gnant A Reiner B Teleky W Seitz R Jakesz (1998) ArticleTitleIt is possible to omit postoperative irradiation in a highly selected group of elderly breast cancer patients Breast Cancer Res Treat 50 37–46 Occurrence Handle10.1023/A:1006064608360 Occurrence Handle9802618

    Article  PubMed  Google Scholar 

  29. U Veronesi E Marubini L Mariani V Galimberti A Luini P Veronesi B Salvadori R Zucali (2001) ArticleTitleRadiotherapy after breast-conserving surgery in small breast carcinoma: Long-term results of a randomized trial Ann Oncol 12 1003–2001 Occurrence Handle10.1023/A:1011136326943

    Article  Google Scholar 

  30. KS Hughes LA Schnaper D Berry C Cirrincione B McCormick B Shank J Wheeler LA Champion TJ Smith BL Smith C Shapiro HB Muss E Winer C Hudis W Wood D Sugarbaker IC Henderson L Norton Cancer B Leukemia Group (2004) ArticleTitleRadiation Therapy Oncology Group, Eastern Cooperative Oncology Group. Lumpectomy plus tamoxifen with or without irradiation in women 70 years of age or older with early breast Cancer N Engl J Med 351 971–977 Occurrence Handle10.1056/NEJMoa040587 Occurrence Handle15342805

    Article  PubMed  Google Scholar 

  31. AW Fyles DR McCready LA Manchul ME Trudeau P Merante M Pintilie LM Weir IA Olivotto (2004) ArticleTitleTamoxifen with or without breast irradiation in women 50 years of age or older with early breast cancer N Engl J Med 351 963–970 Occurrence Handle10.1056/NEJMoa040595 Occurrence Handle15342804

    Article  PubMed  Google Scholar 

  32. M McBoyle H Razek J Carter S Helmer (1997) ArticleTitleTubular carcinoma of the breast: an institutional review Am Surg 63 639–644 Occurrence Handle9202540

    PubMed  Google Scholar 

  33. BG Haffty PL Perrotta B Ward M Moran M Beinfield C McKhann D Fischer D Carter (1997) ArticleTitleConservatively treated breast cancer: outcome by histologic subtype Breast J 3 7–14

    Google Scholar 

  34. H Tobon H Salazar (1977) ArticleTitleTubular carcinoma of the breast. Clinical, histological, and ultrastructural observations Arch Pathol Lab Med 101 310–316 Occurrence Handle193458

    PubMed  Google Scholar 

  35. HA Oberman WJ Fidler (1979) ArticleTitleTubular carcinoma of the breast Am J Surg Pathol 3 387–395 Occurrence Handle532858

    PubMed  Google Scholar 

  36. PH Deos HJ Norris (1982) ArticleTitleWell-differentiated (tubular) carcinoma of the breast. A clinicopathologic study of 145 pure and mixed cases Am J Clin Pathol 78 1–7 Occurrence Handle6285690

    PubMed  Google Scholar 

  37. RW McDivitt W Boyce D Gersell (1982) ArticleTitleTubular carcinoma of the breast. Clinical and pathological observations concerning 135 cases Am J Surg Pathol 6 401–411 Occurrence Handle6289683

    PubMed  Google Scholar 

  38. SJ Schnitt J Hayman R Gelman TJ Eberlein SM Love K Mayzel RT Osteen AJ Nixon S Pierce JL Connolly P Cohen L Schneider B Silver A Recht JR Harris (1996) ArticleTitleA prospective study of conservative surgery alone in the treatment of selected patients with stage I breast cancer Cancer 77 1094–1100 Occurrence Handle10.1002/(SICI)1097-0142(19960315)77:6<1094::AID-CNCR14>3.0.CO;2-X Occurrence Handle8635129

    Article  PubMed  Google Scholar 

  39. WZ Bradford WN Christensen H Fraser TE Cloninger (1998) ArticleTitleTreatment of pure tubular carcinoma of the breast Breast J 4 437–440 Occurrence Handle10.1046/j.1524-4741.1998.460437.x

    Article  Google Scholar 

  40. DW Holland LD Boucher JE Mortimer (2001) ArticleTitleTubular breast cancer experience at Washington University: A review of the literature Clin Breast Cancer 2 210–214 Occurrence Handle11899414

    PubMed  Google Scholar 

  41. L Livi F Paiar E Meldolesi C Talamonti G Simontacchi B Detti S Salerno S Bianchi G Cardona GP Biti (2005) ArticleTitleTubular carcinoma of the breast: Outcome and loco-regional recurrence in 307 patients Eur J Surg Oncol 31 9–12 Occurrence Handle10.1016/j.ejso.2004.09.002 Occurrence Handle15642419

    Article  PubMed  Google Scholar 

  42. AP Forrest HJ Stewart D Everington RJ Prescott CS McArdle AN Harnett DC Smith WD George (1996) ArticleTitleRandomized controlled trial of conservation therapy for breast cancer: 6-year analysis of the Scottish trial Lancet 348 708–713 Occurrence Handle10.1016/S0140-6736(96)02133-2 Occurrence Handle8806289

    Article  PubMed  Google Scholar 

  43. S Renton JC Gazet HT Ford C Corbishley R. Sutcliffe (1996) ArticleTitleThe importance of the resection margin in conservative surgery for breast cancer Eur J Surg Oncol 22 17–22 Occurrence Handle10.1016/S0748-7983(96)91253-6 Occurrence Handle8846860

    Article  PubMed  Google Scholar 

  44. G Liljegren L Holmberg J Bergh A Lindgren L Tabar H Nordgren HO Adami (1999) ArticleTitle10-year results after sector resection with or without postoperative radiotherapy for stage I breast cancer: A randomized trial J Clin Oncol 17 2326–2333 Occurrence Handle10561294

    PubMed  Google Scholar 

  45. P Malmstrom L Holmberg H Anderson J Mattsson PE Jonsson L Tennvall-Nittby G Balldin L Loven JH Svensson C Ingvar (2003) ArticleTitleBreast conservation surgery, with and without radiotherapy, in women with lymph node-negative breast cancer: A randomised clinical trial in a population with access to public mammography screening Eur J Cancer 39 1690–1697 Occurrence Handle10.1016/S0959-8049(03)00324-1 Occurrence Handle12888363

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Harvard Medical School, Boston, MA, USA

    Timothy Sullivan, Rita Abi Raad, Saveli Goldberg, Sherif I. Assaad, Simon N. Powell & Alphonse G. Taghian

  2. Department of Surgical Oncology, Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA, USA

    Michele Gadd & Barbara L. Smith

Authors
  1. Timothy Sullivan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rita Abi Raad
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Saveli Goldberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sherif I. Assaad
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michele Gadd
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Barbara L. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Simon N. Powell
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Alphonse G. Taghian
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alphonse G. Taghian.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sullivan, T., Raad, R.A., Goldberg, S. et al. Tubular Carcinoma of the Breast: a Retrospective Analysis and Review of the Literature. Breast Cancer Res Treat 93, 199–205 (2005). https://doi.org/10.1007/s10549-005-5089-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-005-5089-7

Key words

Search

Navigation