Breast tubular adenoma: diagnostic challenges and management insights from a six-case series

Tubular adenoma is a rare benign breast tumour that is often indistinguishable from fibroadenoma on clinical examination and imaging, making diagnosis and management challenging. We present a six-patient case series describing the clinical, radiological, and histopathological features of this uncommon lesion. Patients ranged from 22 to 62 years of age. Ultrasound consistently demonstrated well-circumscribed hypoechoic lesions with variable internal vascularity, while core biopsy established the diagnosis in all cases. Four patients underwent surgical excision, confirming benign tubular adenoma, and two were managed with surveillance following radiological-pathological concordance. No recurrence, interval growth, or malignant transformation was observed during follow-up. Although tubular adenoma is benign, rare reports of synchronous or adjacent breast carcinoma highlight the importance of histopathological confirmation and careful follow-up. Our findings suggest that selective surveillance may be considered in patients with radiological-pathological concordance, while surgical excision remains appropriate in cases of diagnostic uncertainty, lesion progression, or radiological-pathological discordance.