Tubular Carcinoma of the Breast

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Tubular carcinoma of the breast is a type of invasive ductal breast cancer that accounts for about 2% or less of all breast cancers. It is also more common in women who are over 50 years of age. Tubular breast cancer begins at the breast’s milk duct, like the other types of ductal breast cancers, before spreading to the rest of the breast tissue. Tubular carcinomas are named because of the tube-shaped structures of the tissues when viewed under a microscope. Read More

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Tubular Carcinoma of the Breast

What is Tubular Carcinoma of the Breast?

Tubular carcinoma of the breast is a type of invasive ductal breast cancer that accounts for about 2% or less of all breast cancers. It is also more common in women who are over 50 years of age. Tubular breast cancer begins at the breast’s milk duct, like the other types of ductal breast cancers, before spreading to the rest of the breast tissue. Tubular carcinomas are named because of the tube-shaped structures of the tissues when viewed under a microscope. These tumors are not as aggressive as other types of cancers of the breast and are usually very responsive to treatment. That is, the prognosis is good. The prognosis is also good if the tubular cancer is not mixed with other types of cancer.

Tubular Carcinoma of the Breast
Picture courtesy: ABC

What is the cause of tubular carcinoma of the breast?

The exact cause of this cancer is unknown, but it is generally known that mutations cause breast cancers to the DNA of the cells in the breast. Tubular carcinomas are a result of mutations in the cells of the breast. The cancer then spreads to the other tissues of the breast.

What are the risk factors? 

The factors which increase the risk of getting or developing tubular carcinoma of the breast include:

  • Excessive consumption of alcohol
  • Obesity
  • A family history of breast cancer
  • Infertility
  • Never breastfed a baby
  • Undergoing radiation therapy
  • Undergoing hormone replacement therapy
  • Lack of exercise
  • Unhealthy diet
  • Environmental factors

What are the symptoms of tubular carcinoma of the breast?

The symptoms of tubular breast cancer, as seen in most other breast cancers, can include:

  • A lump or thickening of the skin of the breast
  • Pain in the breast
  • Dimpling or puckering of the breast
  • Change in the size of the breast
  • Changes in the areola or nipples

These symptoms can sometimes go unnoticed by individuals and can be picked up by a routine breast screening in the hospital.

symptoms of tubular carcinoma of the breast
Picture courtesy: Osmosis

How is tubular breast cancer diagnosed?

The symptoms of tubular breast cancer can be rare, so it is first detected during a routine or scheduled mammogram. On discovery, additional tests are usually requested in order to confirm the diagnosis. These additional tests give a lot of information like the stage and severity of the cancer, the adequate and proper treatment as well as the prognosis. Some of these additional tests include:

  • A breast ultrasound
  • Biopsy of the tumor
  • An MRI of the breast
  • A fine needle aspiration
  • A thorough physical examination

One or more of the above tests are usually needed in order to diagnose tubular cancer of the breast properly. This is because the symptoms largely mimic other types of breast cancers. A biopsy is the best and most trusted way to confirm the diagnosis of the disease. However, multiple tests may be needed in order to ensure that the cancer is a pure tubular cancer and not mixed with another subtype of cancer. All this information is also necessary for the doctor to plot a treatment plan for the patient.

What are the treatment options for tubular carcinoma of the breast?

Tubular Carcinoma of the Breast treatment
Picture courtesy: HealthCentral

As seen in many types of breast cancer, the treatment is dependent on some factors like the size of the tissue affected, the grade, etc. The treatment is focused mainly on removing as much of the cancer as possible as well as reducing the risk of it ever returning or spreading to other parts of the body. The most popular treatment option in cases of tubular cancer of the breast includes:

Surgery

Surgery – This is usually the first option considered in people with tubular breast cancer. The two main types of surgery are mastectomy, where all the breast tissue is removed, and breast-conserving surgery, where the cancerous tissue is removed, leaving as much healthy breast tissue as can be afforded. The type of surgery that will be recommended is dependent on the area of the breast that is affected. Women that are going to have mastectomies are usually offered a chance of breast reconstruction surgery.

Some additional treatments that follow surgery which are also referred to as adjuvant therapies, include:

Radiotherapy 

This is where high-energy X-ray beams are used to destroy the cancer cells. It is usually done after the surgery in order to ensure that cancer does not return to the same breast. 

Hormone therapy

This is targeted at some breast cancers that use estrogen to grow. These are known as estrogen receptor-positive breast cancers. Hormone therapy blocks the growth effect of these breast cancers. Different hormone therapy drugs achieve this in different ways. Hormone therapy will only be recommended if the cancer has been confirmed as an estrogen receptor-positive cancer. Invasive breast tissues are confirmed to be ER+ following tests on tissues gotten through biopsy or after surgery. The doctor then discusses the type of hormone therapy to be used and the length of time it should be used. Tubular breast cancers are usually ER+. 

Chemotherapy

This method uses drugs to destroy cancer tissues. It is administered after surgery to reduce the risk of the spread or the return of the cancer. This method is not usually administered in tubular breast cancer. This is because the cancer is almost always low-grade and much less likely to spread to other parts of the body. 

Targeted therapy

This is a special group of drugs that target a particular thing in the cancer cell. They usually target and interfere with processes in the cells that aid the growth of the cancer. The type of targeted treatment approach is dependent on the features of the tumor. The most widely used variety of targeted therapies is the ones for HER2-positive breast cancers. HER2 is a protein that aids in the growth of cancers, only individuals with very high levels of HER2 will benefit from this type of therapy. The levels are determined with tissues that are obtained from biopsies or after surgery.

The aim of these treatments is to reduce the risk of breast cancer returning to the same breast tissue, spreading out in the body, or developing in other breast tissue. Some of these treatments can also be administered before the surgery, where they are then referred to as the primary treatment.

What is the outlook for patients?

Women who have scheduled mammograms usually get their tubular cancer detected earlier than others. This is very important in every type of breast cancer, so it is advised for women to have at least one mammogram done in a year. Tubular breast cancer has an excellent prognosis, especially when detected early. Its less aggressive nature also contributes to its good prognosis. The cancer responds well to treatment and rarely spreads beyond the breast tissue. The outlook of the disease is good even after treatment if the cancer is a “pure” tubular cancer that is not mixed with other subtypes.