Difference between revisions of "Tubular carcinoma of the breast"

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#redirect [[Invasive_breast_cancer#Tubular_carcinoma_of_the_breast]]
'''Tubular carcinoma of the breast''' is an uncommon for of [[invasive breast cancer]] that at first glance may look like benign breast tissue.


*[[AKA]] ''tubular carcinoma''.
==General==
Epidemiology:
*Typically excellent prognosis.
*Hormone receptors commonly present (ER +ve, PR +ve).
*Usually HER2 -ve.
*Classically seen in post-menopausal women.
Note:
*May be seen in association with [[lobular carcinoma in situ]] and columnar cell lesions - known as '''Rosen triad'''.<ref name=pmid18434766>{{Cite journal  | last1 = Brandt | first1 = SM. | last2 = Young | first2 = GQ. | last3 = Hoda | first3 = SA. | title = The "Rosen Triad": tubular carcinoma, lobular carcinoma in situ, and columnar cell lesions. | journal = Adv Anat Pathol | volume = 15 | issue = 3 | pages = 140-6 | month = May | year = 2008 | doi = 10.1097/PAP.0b013e31816ff313 | PMID = 18434766 }}</ref>
**Memory device ''TLC'' = '''T'''ubular ca., '''L'''CIS, '''C'''olumnar cell lesions.
==Microscopic==
Features:<ref name=Ref_PBoD1146>{{Ref PBoD|1146}}</ref><ref>URL: [http://www.bweems.com/nsj3mp2.jpg http://www.bweems.com/nsj3mp2.jpg].</ref><ref>URL: [http://surgpathcriteria.stanford.edu/breast/tubularcabr/ http://surgpathcriteria.stanford.edu/breast/tubularcabr/].</ref>
*Well-formed tubules.
**Typically have angled ducts - "prows" - '''important feature''' (low power).
**Myoepithelial cells absent - diagnostic - may be have to appreciated without IHC.
**>70% of the tumour cells should be adjacent to lumen.<ref name=pmid10836300>{{Cite journal  | last1 = Stalsberg | first1 = H. | last2 = Hartmann | first2 = WH. | title = The delimitation of tubular carcinoma of the breast. | journal = Hum Pathol | volume = 31 | issue = 5 | pages = 601-7 | month = May | year = 2000 | doi =  | PMID = 10836300 }}</ref>
*+/- Cribriform spaces.
*Apocrine snouts typical.
*+/-Calcification.
Notes:
*Prow = front of a ship.
*Looks benign to the uninitiated -- '''important'''.
DDx:
*[[Sclerosing adenosis]].
*[[Microglandular adenosis]].
===Images===
www:
*[http://radiology.uchc.edu/eAtlas/Breast/1714.htm Tubular carcinoma - (uchc.edu)].
==IHC==
*ER +ve.
*PR +ve.
*HER2 -ve.
**HER2 positivity should prompt consideration of another diagnosis!
==See also==
*[[Invasive breast cancer]].
==References==
{{Reflist|2}}
[[Category:Invasive breast cancer]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 11:10, 14 February 2014

Tubular carcinoma of the breast is an uncommon for of invasive breast cancer that at first glance may look like benign breast tissue.

  • AKA tubular carcinoma.

General

Epidemiology:

  • Typically excellent prognosis.
  • Hormone receptors commonly present (ER +ve, PR +ve).
  • Usually HER2 -ve.
  • Classically seen in post-menopausal women.

Note:

  • May be seen in association with lobular carcinoma in situ and columnar cell lesions - known as Rosen triad.[1]
    • Memory device TLC = Tubular ca., LCIS, Columnar cell lesions.

Microscopic

Features:[2][3][4]

  • Well-formed tubules.
    • Typically have angled ducts - "prows" - important feature (low power).
    • Myoepithelial cells absent - diagnostic - may be have to appreciated without IHC.
    • >70% of the tumour cells should be adjacent to lumen.[5]
  • +/- Cribriform spaces.
  • Apocrine snouts typical.
  • +/-Calcification.

Notes:

  • Prow = front of a ship.
  • Looks benign to the uninitiated -- important.

DDx:

Images

www:

IHC

  • ER +ve.
  • PR +ve.
  • HER2 -ve.
    • HER2 positivity should prompt consideration of another diagnosis!

See also

References

  1. ↑ Brandt, SM.; Young, GQ.; Hoda, SA. (May 2008). "The "Rosen Triad": tubular carcinoma, lobular carcinoma in situ, and columnar cell lesions.". Adv Anat Pathol 15 (3): 140-6. doi:10.1097/PAP.0b013e31816ff313. PMID 18434766.
  2. ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1146. ISBN 0-7216-0187-1.
  3. ↑ URL: http://www.bweems.com/nsj3mp2.jpg.
  4. ↑ URL: http://surgpathcriteria.stanford.edu/breast/tubularcabr/.
  5. ↑ Stalsberg, H.; Hartmann, WH. (May 2000). "The delimitation of tubular carcinoma of the breast.". Hum Pathol 31 (5): 601-7. PMID 10836300.
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