TUBULAR CARCINOMA OF THE BREAST - MODE OF PRESENTATION, MAMMOGRAPHIC APPEARANCE, AND FREQUENCY OF NODAL METASTASES

OBJECTIVE. Tubular carcinoma of the breast is a distinct, well-differentiated histologic subtype of infiltrative adenocarcinoma. The purpose of this study was to determine the typical mode of presentation, mammographic appearance, and frequency of metastases to the axillary lymph nodes. MATERIALS AND METHODS. We retrospectively analyzed the clinical records, mammograms, and histologic slides of 20 cases of proved tubular carcinoma of the breast in 20 women. These patients were identified by computerized search of our pathology data base from 1984 to 1993. Histologic findings were reviewed in all cases and correlated with the mammographic findings. RESULTS. Thirteen (65%) of the 20 women had impalpable tubular cancers discovered on screening mammograms. Seven patients (35%) had mammography because of a palpable tumor. Abnormalities were seen on mammograms in 16 patients (80%). These consisted of a mass alone in 13 (65%), a mass with microcalcifications in two (10%), and calcifications associated with architectural distortion and asymmetric density in one (5%). Most masses (11/15, 73%) were irregular or spherical and had spiculated margins. The size of the masses ranged from 3 to 19 mm (median, 8 mm). Metastatic carcinoma was found in the axillary lymph nodes of four (29%) of 14 patients who had axillary lymph node dissections, three of whom had a primary tumor 1 cm or less in diameter. CONCLUSION. Tubular cancers were most frequently detected as impalpable abnormalities seen on mammograms, emphasizing the importance of screening mammography. However, tubular carcinomas did not have a unique appearance on mammograms that would allow differentiation from other carcinomas. Lymph node metastases were more common than has been previously reported for this type of tumor, indicating that axillary lymph node dissections should continue to be performed.