Tubular carcinoma of the breast

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Tubular carcinoma of the breast
Diagnosis in short

LM well-formed tubules - typically with angled ducts ("prows"), myoepithelial cells absent - diagnostic (may be have to appreciated without IHC), >70% of the tumour cells should be adjacent to lumen, +/-cribriform spaces, apocrine snouts typical, +/-calcifications
LM DDx sclerosing adenosis, microglandular adenosis
IHC ER +ve, PR +ve, HER2 -ve
Grossing notes breast grossing
Staging breast cancer staging
Site breast - see invasive breast cancer

Prevalence uncommon
Prognosis good relative to NST
Clin. DDx other breast tumours

Tubular carcinoma of the breast, also tubular carcinoma, is an uncommon for of invasive breast cancer that at first glance may look like benign breast tissue.

General

Epidemiology:

  • Typically excellent prognosis.
  • Hormone receptors commonly present (ER +ve, PR +ve).
  • Usually HER2 -ve.
  • Classically seen in post-menopausal women.

Note:

  • May be seen in association with lobular carcinoma in situ and columnar cell lesions - known as Rosen triad.[1]
    • Memory device TLC = Tubular ca., LCIS, Columnar cell lesions.

Microscopic

Features:[2][3][4]

  • Well-formed tubules.
    • Typically have angled ducts - "prows" - important feature (low power).
    • Myoepithelial cells absent - diagnostic - may be have to appreciated without IHC.
    • >70% of the tumour cells should be adjacent to lumen.[5]
  • +/- Cribriform spaces.
  • Apocrine snouts typical.
  • +/-Calcification.

Notes:

  • Prow = front of a ship.
  • Looks benign to the uninitiated -- important.

DDx:

Images

www:

IHC

  • ER +ve.
  • PR +ve.
  • HER2 -ve.
    • HER2 positivity should prompt consideration of another diagnosis!

See also

References

  1. Brandt, SM.; Young, GQ.; Hoda, SA. (May 2008). "The "Rosen Triad": tubular carcinoma, lobular carcinoma in situ, and columnar cell lesions.". Adv Anat Pathol 15 (3): 140-6. doi:10.1097/PAP.0b013e31816ff313. PMID 18434766.
  2. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1146. ISBN 0-7216-0187-1.
  3. URL: http://www.bweems.com/nsj3mp2.jpg.
  4. URL: http://surgpathcriteria.stanford.edu/breast/tubularcabr/.
  5. Stalsberg, H.; Hartmann, WH. (May 2000). "The delimitation of tubular carcinoma of the breast.". Hum Pathol 31 (5): 601-7. PMID 10836300.