TUBULAR CARCINOMA OF THE BREAST - PREDICTING AXILLARY NODAL METASTASES AND RECURRENCE

Background Tubular carcinoma of the breast, a well-differentiated vari ant of infiltrating ductal carcinoma, has been regarded as a very favo rable histologic subtype. The infrequency of nodal metastases and low recurrence rates have led to questions about the value of axillary dis section. Objective The authors evaluated the frequency of axillary nod al metastases, the prognostic value of histologic features of the prim ary tumor, and treatment outcome in patients with tubular carcinoma of the breast. Methods This retrospective analysis evaluated 50 patients who received diagnoses of tubular carcinoma from The University of Te xas M. D. Anderson Cancer Center between 1944 and 1992. Medical record s were reviewed for information about the patient, the tumor, treatmen t, and outcome. Hematoxylin-eosin-stained sections were reviewed to co nfirm the diagnosis and assess histologic features. Results The median tumor diameter was 1.0 cm. Nine (20%) of 44 axilla had histologically confirmed lymph node involvement. Lymph node involvement was neither infrequent nor predicted by features of the primary tumor. Recurrences developed in 4 patients, and 1 patient died of tubular carcinoma. The 5-year disease-free survival rate was 88%. The local therapy used, ma stectomy or breast preservation, did not affect disease-free survival. Contralateral cancer was noted in 26% of the patients. Conclusions Ax illary metastases occur in 20% of patients and are not predicted by fe atures of the primary tumor. Breast preservation is a safe treatment o ption for tubular carcinoma of the breast.