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Better prognosis seen with tubular breast cancer versus grade I ductal cancer

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – New research confirms that tubular carcinoma (TC) of the breast has an excellent prognosis and goes on to show that outcomes are better than with grade I ductal carcinomas.

“Although TC is known to have a favorable prognosis, it is still unknown whether this subtype represents a distinct type of breast carcinoma or whether it behaves like other low-grade luminal A-type breast carcinomas,” Dr. Emad A. Rakha and colleagues, from Nottingham University Hospitals in the UK, explain.

To investigate, the researchers analyzed data from 2608 primary operable invasive breast carcinomas entered in the Nottingham Primary Breast Carcinoma Series from 1989 to 2000. The study focused on the 102 TCs and the 212 grade 1 ductal carcinomas included in the dataset.

Relative to grade 1 ductal carcinoma, TC was more likely to be identified on mammographic screening, had smaller median size, and was less likely to have lymphovascular invasion, according to the report in the November 16th online issue of the Journal of Clinical Oncology.

During a median follow-up of 127 months, both disease-free (p < 0.001) and breast cancer-specific (p = 0.003) survival were significantly better with TC than with grade 1 ductal carcinoma.

None of the patients with confirmed TC developed distant metastases or died from their disease. Two patients who were initially thought to have TC developed distant metastases and one died from the disease, but on further analysis, their tumor histology was revised to grade 1 ductal carcinoma.

“TC is increasingly encountered in recent years as a result of the widespread use of and the advances in mammographic screening and can be managed by adequate local surgical treatment,” the authors conclude. “Adjuvant hormonal treatment may be appropriate in patients with evidence of nodal metastases at presentation, but chemotherapy does not seem to be justified in patients without distant metastases.”

Reference:
J Clin Oncol 2009.