Tubular carcinoma of the breast: Sensitivity of diagnostic techniques and correlation with histopathology

OBJECTIVE, Our objective was to assess our experience in diagnosing pure tu bular carcinoma of the breast and to correlate the radiologic and histopath ologic features. MATERIALS AND METHODS. A retrospective review of 932 consecutive cases of p roven breast cancer diagnosed between 1990 and 1997 revealed 78 cases (8.4% ) of tubular carcinoma in 69 patients. Clinical, imaging, cytologic, and hi stologic findings were analyzed. RESULTS. Mammography revealed tubular carcinoma in 68 (87%) of the 78 cases . Sonography showed tubular carcinoma in all 38 cases in which it was used; nine of these lesions were mammographically occult. These nine lesions wer e slightly, but not significantly (p <.05), smaller than the 29 lesions tha t had also been detected on mammography. Large core needle biopsy was perfo rmed in 22 patients (sensitivity, 91%). At biopsy, diagnoses were malignant (n = 16 [73%]), suspicious (n = 4 [18%]), atypia (n = 1 [4.5%]), and benig n (n = 1 [4.5%]). Fine-needle aspiration biopsy was used to evaluate 36 cas es of tubular carcinoma (sensitivity, 50%); cytologic diagnoses were malign ant (n = 15 [42%]), suspicious (n = 3 [8%]), atypia (n = 10 [28%]), and ben ign (n = 8 [22%]). Only 15 (19%) of the 78 tubular car cinemas were palpabl e. Other tumors were detected within the excised tissue in 47 of the patien ts (68%); of these other types of lesions, ductal carcinoma in situ was fou nd most often. CONCLUSION. Most cases of tubular carcinoma can be revealed by mammography; for mammographically occult tubular carcinoma, sonography can be performed . The rate of accuracy for determining the presence of tubular carcinoma is higher with large core needle biopsy than with fine-needle aspiration biop sy. Finally, when tubular carcinoma is diagnosed, other histologic types of carcinoma often occur in the same breast.