Axillary Dissection for Tubular Carcinoma of the Breast

Berger, Adam C.; Miller, Stephen M.; Harris, Matthew N.; Roses, Daniel F.

doi:10.1111/j.1524-4741.1996.tb00096.x

Cited by 15 publications

(9 citation statements)

References 15 publications

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“…The reported incidence of axillary nodal metastases at presentation in TCB varies between 0% and 29%(1,4–7,12,21–25). However, in studies confined to “pure” TCB, the incidence was between 0% and 8%(4,6,7).…”

Section: Discussionmentioning

confidence: 99%

Tubular Carcinoma of the Breast: A Population-Based Study of Nodal Metastases at Presentation and of Patterns of Relapse

et al. 2001

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Tubular carcinoma of the breast (TCB) is a recognized histologic variant of infiltrating ductal carcinoma (IDC) and has been considered to have a comparatively favorable prognosis. However, previous studies have been based on small numbers of cases, some pure TCB and some mixed histology, or have not employed an appropriate comparison group. In this study 171 pure TCB cases and a comparison group of 386 cases with grade I (well differentiated) IDC were identified in a population-based database maintained by the British Columbia Cancer Agency (BCCA). The proportion of cases with axillary nodal involvement at presentation was lower in TCB cases than in the grade I IDC comparison group (12.9% and 23.9%, respectively; p < 0.05). Low-risk tumors (T1 and without vascular lymphatic or perineural invasion) were more prevalent in the TCB patients than in the grade I IDC patients (66.7% and 60.0%; p < 0.05). Low-risk TCB cases had a significantly lower rate of nodal metastases at presentation than low-risk grade I IDC cases (7.0% and 13.2%; p < 0.05). Kaplan-Meier and log-rank analyses indicated a statistically significantly lower rate of local recurrence in TCB cases than among IDC cases (p < 0.05) and a trend toward a lower rate of systemic relapse in TCB cases (p = 0.07). However, no difference in disease-specific survival was observed between TCB cases and grade I IDC comparisons. We conclude that the biologic behavior of TCB was more favorable than that of a comparison group of IDC cases. In view of the low incidence of axillary node metastases at presentation in the low-risk TCB subset (7%), axillary dissection may be omitted as part of the initial surgical management in these patients.

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Section: Discussionmentioning

confidence: 99%

Tubular Carcinoma of the Breast: A Population-Based Study of Nodal Metastases at Presentation and of Patterns of Relapse

et al. 2001

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“…Even though hyperintense signal with dark internal septations of TC on T2-W images of MR imaging is similar to fibroadenoma, dynamic analysis with early and delayed enhancement patterns, ADC values and advanced age help to differentiate TC from this benign entity on MR imaging. Tubular carcinoma has been reported to be related with other types of carcinomas and associated with other histologic entities (4,23,24). In this study, one patient with DCIS in another quadrant of the same breast and one patient with invasive ductal carcinoma in the same quadrant were reported.…”

Section: Discussionmentioning

confidence: 71%

MR Imaging Features of Tubular Carcinoma: Preliminary Experience in Twelve Masses

Yılmaz

Bayramoğlu

Emirikçi

et al. 2018

Eur J Breast Health

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Objective: We retrospectively analyzed the magnetic resonance (MR) imaging features and diffusion-weighted imaging findings of the 12 masses of 10 patients with tubular carcinoma (TC), including mammography and sonography findings. Materials and Methods:Mammographic, sonographic and magnetic resonance imaging features in 12 histopathologically confirmed masses diagnosed as TC of the breast within 10 patients were evaluated. Morphologic characteristics, enhancement features, apparent diffusion coefficient (ADC) values were reviewed.Results: On mammography (n=5), TC appeared as high density masses with indistinct, spiculated or obscured margins. Sonographically, TC appeared as a hypoechoic appearance (n=12) with posterior acoustic shadowing in nine. On MR imaging, the margins of ten of twelve masses were irregular. Internal enhancement patterns were heterogeneous in 10 patients. Dynamic enhancement patterns illustrated plateau kinetics (n=8). On the T2-weighted images 4 masses were hypointense, and 8 were hyperintense; hypointense internal septation was found in seven of these. Tubular carcinoma appeared as hyperintense on diffusion-weighted imaging with ADC values of 0.85±0.16x10-3 mm 2 /s that was lower than the normal parenchyma of 1.25±0.25x10-3 mm 2 /s. Conclusion:According to our study with a limited number of cases, tubular carcinomas can be described as hyperintense breast carcinomas with or without dark internal septation like appearance on T2-weighted images. Low ADC values from DW imaging can be used to differentiate TC from hyperintense benign breast lesions.

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“…As previously described, the risk of axillary lymph node metastases is extremely low in patients with ductal carcinoma in situ (DCIS) (58,59), microinvasive carcinoma (60,61), and pure tubular carcinoma of less than 1 cm (64)(65)(66). These patients probably would not benefit from an ALND.…”

Section: Selecti6e Alndmentioning

confidence: 98%

Axillary Lymph Node Dissection in Breast Cancer: Current Status and Controversies, Alternative Strategies and Future Perspectives

Sakorafas

Tsiotou²,

Balsiger³

2000

Acta Oncologica

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Axillary lymph node dissection (ALND) has traditionally been considered as a standard procedure in the surgical management of patients with breast cancer. The goals of ALND in breast cancer surgery are: (a) to provide accurate prognostic information, (b) to maintain local control of the disease in the axilla and (c) to provide a rational basis for decisions about adjuvant therapy. Although controversial, ALND may also be associated with a small therapeutic benefit. Recently, the question of whether ALND is needed for every patient with invasive breast cancer has been the subject of ongoing debate in the literature. This is mainly due to the widespread use of adjuvant systemic therapy for patients with node-negative breast cancer and to the increasingly frequent detection of small invasive cancers by mammographic screening; the majority of these patients have negative axillae. Sentinel lymph node (SLN) biopsy is a new, promising, minimally invasive procedure, which accurately predicts nodal status with minimal morbidity, and reserves ALND for patients with positive SLN biopsies. However, this method is still investigational. Partial (levels I and II) ALND remains the gold standard in the surgical management of patients with breast cancer.

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Axillary Dissection for Tubular Carcinoma of the Breast

Cited by 15 publications

References 15 publications

Tubular Carcinoma of the Breast: A Population-Based Study of Nodal Metastases at Presentation and of Patterns of Relapse

Tubular Carcinoma of the Breast: A Population-Based Study of Nodal Metastases at Presentation and of Patterns of Relapse

MR Imaging Features of Tubular Carcinoma: Preliminary Experience in Twelve Masses

Axillary Lymph Node Dissection in Breast Cancer: Current Status and Controversies, Alternative Strategies and Future Perspectives

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