Tubular carcinoma of the breast: Prognosis and response to adjuvant systemic therapy

Background: Tubular carcinoma of the breast is an uncommon and usually smal l tumour, and is thought to have a favourable prognosis. The present study examined the long-term prognosis of patients with tubular breast carcinoma and the roles of axillary dissection and adjuvant therapy. Methods: Eighty-six tubular cases were identified from a large worldwide da tabase of 9520 breast carcinoma patients entered into randomized adjuvant t herapy trials run by the International Breast Cancer Study Group from 1978 to 1999. These patients were followed for a median of 12 years. Results: Forty-two (49%) cases were node-positive, of which 33 (79%) had 1- 3 nodes involved. Ten (32%) of the 31 smaller tumours (less than or equal t o 1 cm in size) were node-positive. Patients with node-positive tubular car cinoma had a significantly better 10-year relapse-free survival (P = 0.006) and survival (P < 0.0001) compared with non-tubular node-positive cases. O verall survival was similar for node-positive and node-negative tubular car cinoma. Overall, 71 patients (83%) received some form of adjuvant systemic therapy. Of the 86 cases, 43 (50%) received more than one course of chemoth erapy. There was an 85% decrease in the risk of death for patients who rece ived more than one course of chemotherapy compared to those who did not (ha zard ratio 0.15, 95% confidence interval (CI): 0.03-0.82; P = 0.03). Conclusions: Compared to other histological types of breast cancer, tubular carcinoma has a better long-term prognosis. Adjuvant chemotherapy may furt her improve prognosis and involvement of axillary nodes may not be an indic ator for early death due to breast carcinoma.