Tubular carcinoma of the breast. Clinical pathologic correlations based on 100 cases

One hundred tubular carcinomas were reviewed, analyzed and compared with previously reported studies in the literature. Our cases were subdivided into five groups, according to the proportion of the carcinoma which was tubular. In the case of pure or almost pure tubular carcinomas (76% or more), tumor size was small, no metastases were found, no recurrences developed, and there were no deaths attributable to the carcinoma. As the proportion of the carcinoma which was tubular decreased, the size and biologic aggressiveness of the tumor increased; this it is likely that tubular carcinoma may represent an early form of carcinoma. A right-sided preponderance was found of the "pure tubular" carcinomas; and lesions of the central sector of the breast were rare in all five groups. The incidence of bilateral cancer was greater than that expected for breast cancer in general and included three patients with bilateral tubular carcinomas. On the basis of our findings, we suggest that lesions which are composed 90% or more of tubular carcinoma may be treated by simple mastectomy, and that axillary dissection is not necessary. For all carcinomas with a lower proportion of tubular elements, at least total mastectomy and axillary dissection are indicated, although the safest treatment probably is radical mastectomy.