Tubular breast cancer is a type of invasive breast cancer. This means that cancer cells started in the milk ducts but have spread into the surrounding breast tissue.
It’s called tubular breast cancer because the cancer cells form tube-shaped structures when looked at under a microscope.
It accounts for between 5 and 10% of all breast cancers, and it’s often found alongside other types of breast cancer.
Tubular breast cancer is most common in women over 50, although you can get it at any age. It’s very rare in men.
Generally, tubular breast cancer has a very good prognosis (outlook) following treatment. This is because the cells are nearly always low grade and slow growing – cancer cells are graded according to how different they are to normal breast cells and how quickly they’re growing.
It’s also less likely than other breast cancers to spread to the lymph nodes (glands) under the arm (axilla) or outside the breast.
The outlook is particularly good if the cancer is ‘pure’ tubular, which means it’s not mixed with other types of breast cancer.
How is tubular breast cancer diagnosed?
Tubular breast cancer is diagnosed using a range of tests. These include a mammogram (breast x-ray) and an ultrasound scan, followed by a core biopsy or fine needle aspiration (FNA).
Most tubular breast cancers are detected during routine breast screening.
How is tubular breast cancer treated?
The features of your tubular breast cancer will affect what treatments you’ll be offered.
Surgery is usually the first treatment for tubular breast cancer.
This is most likely to be breast-conserving surgery, usually called wide local excision or lumpectomy – removal of the cancer with a margin (border) of normal breast tissue around it.
Less commonly, a mastectomy may be recommended to remove of all the breast tissue including the nipple area.
The type of surgery recommended depends on the area of the breast affected, the size of the cancer relative to the size of your breast and whether more than one area in the breast is affected. Your breast surgeon will discuss this with you.
Sometimes more surgery is needed if the margin of normal tissue surrounding the cancer that was removed during the first operation is not clear. This is to ensure that all the cancer has been removed. In some cases, this second operation will be a mastectomy.
If you’re going to have a mastectomy, you’ll usually be able to have breast reconstruction. This can be done at the same time as your mastectomy (immediate reconstruction) or months or years later (delayed reconstruction).
Surgery to the lymph nodes
Tubular breast cancer is less likely to spread to the lymph nodes (glands) under the arm than most other types of breast cancer.
However, your specialist team will want to check this to help them decide whether or not you’ll benefit from any additional treatment after surgery. To do this, your surgeon is likely to recommend an operation to remove either some of the lymph nodes (a lymph node sample or biopsy) or all of them (a lymph node clearance).
Sentinel lymph node biopsy is widely used for people with breast cancer whose tests before surgery show no evidence of the lymph nodes containing cancer cells. It identifies whether or not the first lymph node (or nodes) is clear of cancer cells. If it is, this usually means the other nodes are clear too, so no more will need to be removed.
If the results of the sentinel lymph node biopsy show that the first node or nodes are affected, you may be recommended to have further surgery or radiotherapy to the remaining lymph nodes.
Find out more about surgery to the lymph nodes.
What are the adjuvant (additional) treatments?
After surgery, you may need further treatment. This is called adjuvant (additional) therapy and can include:
- hormone therapy
- targeted therapy.
The aim of these treatments is to reduce the risk of breast cancer returning in the same breast or developing in the opposite breast, or spreading somewhere else in the body.
Radiotherapy uses high energy x-rays to destroy any cancer cells that may be left behind in the breast area after surgery. If you have breast-conserving surgery, you’ll usually be given radiotherapy to reduce the risk of breast cancer cells returning in the same breast. Sometimes you may be offered radiotherapy to the nodes under your arm.
Radiotherapy may sometimes be given after a mastectomy, for example when several lymph nodes under the arm contain cancer cells, but this is unlikely with tubular breast cancer.
Hormone (endocrine) therapy
As the female hormone oestrogen can play a part in stimulating some breast cancers to grow, several hormone therapies work in different ways to block the effect of oestrogen on cancer cells.
Hormone therapy will only be prescribed if your breast cancer has receptors within the cells that bind to oestrogen and stimulate the cancer to grow. This is known as oestrogen receptor positive or ER+ breast cancer.
Tubular breast cancers are usually oestrogen receptor positive. Your specialist will discuss with you which drug they think is most suitable.
Chemotherapy uses anti-cancer (also called cytotoxic) drugs which aim to destroy cancer cells. People diagnosed with tubular breast cancer don’t usually have chemotherapy. This is because tubular breast cancer is almost always low grade and much less likely than some other types of breast cancer to spread to other areas of the body.
However, it may be recommended for some people.
Targeted therapies (sometimes called biological therapies)
This is a group of drugs that block the growth and spread of cancer. They target and interfere with processes in the cells that cause cancer to grow. The most widely-used targeted therapy is trastuzumab (Herceptin).
Only people whose cancer has high levels of HER2 (called HER2 positive) will benefit from having trastuzumab. HER2 is a protein that makes cancer cells grow.
However, tubular breast cancer is likely to be HER2 negative.