Tubular carcinoma is a rare subtype of IDC- invasive ductal carcinoma. In it cancer cells look like and are made up of small tubes of about 1cm or less, giving this cancer its name of tubular carcinoma. It is quite rare as in it only makes 2% of all breast cancer detections and the incidence is higher in women aged more than 50years. Also it is quite rare in men. These tumors are slow growth tumors; yes it is invasive in nature but not very aggressive and can easily be treated. There are times when there is a mixed tumor diagnosis when tubular cancerous cells are present with ductal cancer cells. It is called TLC – tubulolobular cancer when combined with lobular cancer. You should not mix it with tubular breasts which is a congenital condition which gives the breast drooping shape, large areola section and narrow at the chest wall. These are two separate conditions. Tubular carcinomas are usually not found in isolation but cancers like DCIS or LCIS(lobular carcinoma in situ) are also present. Once a patient has been detected with tubular carcinoma, there are chances that within the same breast or even in the second breast there are more cancerous cells.
A good percentage of women have been historically seen to have cancer in the other breast if they have tubular cancer in one of the breasts. This other cancer in the second breast most commonly is IDC.
Tubular carcinoma does usually manifest itself with obvious signs and symptoms of the heart. Initially like there may be no symptoms similar to other cancers and there may be no lump. This though may be exhibited in mammogram imaging. In time with growth, the lump may be felt in physical examination. Also if it is mixed with IDC or a tubulobular cancer then it may form a lump or a firm thickening in the breast.
Tubular carcinomas are usually very small in size – 1 to 2cm in diameter and are seen first in mammograms but they can appear quite similar to IDC in mammogram with same projecting margins. So further screening is required to distinguish between the two cancers and diagnose actual tubular tumor cells. This cancer can but it does not usually spread to lymph nodes, thus has a good prognosis with reduced likeliness of metastasis.
The usual routine of physical examination is followed by a mammogram for irregular outline mass, followed by MRI or breast ultrasound for calcifications detection of dead cancer cells. The imaging would show a denser central area than the peripheral lump areas.
Biopsy is a tissue scanning test which involves removal of cancer tissue for analysis under a microscope. The tissue is withdrawn by making a small incision and inserting a needle. A pathologist if finds tubular shaped cancer cells, it is confirmed that that the diagnosis is tubular carcinoma. Mostly it is a mixed tubular carcinoma but if there are more than 905 of tubular cancerous cells present in the tissue then it is categorized as tubular carcinoma. Tubular carcinoma has better progonosis as compared to mixed carcinoma as it is more likely to be restricted to primary site of eruption.
There are two other features associated with a pure tubular carcinoma which are:
Hormone-receptor-positive (HR+) status and HER2-negative (HER2-) status. HR+ status is a positive affinity for estrogen hormone receptor (70 - 100%) and a positive affinity for hormone progesterone 60 – 80% times. As regards the second feature of HER2-, these imply the negative affinity of tubular cancers for the receptor for protein HER2-. The good thing about these two features of tubular carcinoma is that with these parameters the tubular carcinomas tend to remain small and stay restricted to the primary breast. These features attribute the growth to be less aggressive and confined.