Tubular carcinoma of the breast. Predicting axillary nodal metastases and recurrence.

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BACKGROUND: Tubular carcinoma of the breast, a well-differentiated variant of infiltrating ductal carcinoma, has been regarded as a very favorable histologic subtype. The infrequency of nodal metastases and low recurrence rates have led to questions about the value of axillary dissection. OBJECTIVE: The authors evaluated the frequency of axillary nodal metastases, the prognostic value of histologic features of the primary 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 Texas M. D. Anderson Cancer Center between 1944 and 1992. Medical records were reviewed for information about the patient, the tumor, treatment, and outcome. Hematoxylin-eosin stained sections were reviewed to confirm 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, mastectomy or breast preservation, did not affect disease-free survival. Contralateral cancer was noted in 26% of the patients. CONCLUSIONS: Axillary metastases occur in 20% of patients and are not predicted by features of the primary tumor. Breast preservation is a safe treatment option for tubular carcinoma of the breast.

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