tubular carcinoma
Comments
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Hi 614,
Sorry it took a while to respond - but as I stated earlier on July 22, I had to have a biopsy on my left breast (BC was on the right side). I did hear back from my radiologist and everything is BENIGN. So very relieved. He did put a marker in and I will have another ultrasound in six months to follow up the biopsy site. I also have a lot of calcifications scattered throughout, so they want to make sure everything is stable with them. I am just now realizing that I have to deal with this "six months at a time". Good luck to us all.
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Dear Nana:Sorry about the time that it has taken for me to respond to you as well. I am so glad that you had benign findings. Yay! Yes, the 6 months of surveillance while comforting to be watched so closely, is very stressful because it is scary to know that something could be there.
Good luck,
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Question:
When I was originally diagnosed from a core needle biopsy, the path report came back as "infiltrating tubular carcinoma of the breast." After surgery, the path report said, "Tubular formations 70% of the tumor." This was rated 2 on the Scarff Bloom-Richardson scale.
Would that still be considered a tubular type by some labs? Or does it have to be at least 90%?
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Well, duh, I answered my own question (from the bc.org site). I guess the tumor would have been considered "mixed tubular."
When a pathologist examines the tumor samples under a microscope, he or she looks for the tube-shaped structures that give tubular carcinoma its name. Experts generally agree that more than 90% of the tumor must have this characteristic appearance in order to be called "pure" tubular carcinoma. If it doesn't, then it is diagnosed as a "mixed" tubular carcinoma. The more "tubular" it is, the less likely it is to spread and the easier it should be to treat.
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latest retrospective tubular treatment and recurrence....
http://www.ncbi.nlm.nih.gov/pubmed/26387144
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Even though PR- tumors are thought to be more aggressive than PR+, the fact that it's tubular may tilt towards skipping chemo. The fact it's tubular may also mean that Oncotype DX testing may not be needed--it's usually not done if all other factors indicate chemo is unnecessary
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I have just been diagnosed with pure Tubular Breast Cancer. If you had pure tubular how were you treated what was the plan? What I have been reading on the web is just to have it removed and that is about it. Mine is just on the bubble being 1.1cm. I had very wide margins and clear nodes, hormone positive. I am not sure if radiation will be the next step? I don't know about the Her status or if I will be on hormone replacement?
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I had pure tubular and I did do radiation; I had 15 plus 5 boosts. I am also on Letrozole--it doesn't replace hormones, it blocks estrogen. Prior to having the tubular cancer, I also had DCIS in the other breast, so the Letrozole is because of both--not sure if I would be taking it for only the tubular.
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I'm pretty sure radiation is the standard of care if you have a lumpectomy, regardless of the type of tumor. Having good margins and no positive nodes might allow you to skip RADS with some peace of mind though. From what I've read, women with tubular BC are not offered a hormonal if they have negative nodes and a tumor under 1 cm/10mm. Because yours is over one cm you may be offered an anti-hormonal. I was offered tamoxifen due to a positive node, although I've refused it thus far, my OC while recommending it, didn't really push it or demand I take it.
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I won't have any news on treatment for about another 4 weeks. As well there is not a ton on the web. I am up for all levels of treatment just want to understand more about howothers have been treated.
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Hi, I was just diagnosed with Tubular Carcinoma yesterday, Feb 10, 2016. Here are the findings of the utrrasound and Biopsy:
BREAST COMPOSITION: Scattered fibroglandular densities.
FINDINGS: There is a 4.6 mm irregular shaped slightly spiculated nodular density in the upper inner quadrant of the left breast. Ultrasound shows a solid 0.43 x 0.27 x 0.34 cm hypoechoic nodule at this site. IMPRESSION: SOLID APPROXIMATE 0.43 CM NODULE IN THE 10:00 POSITION LEFT BREAST 5 CM FROM THE NIPPLE WHICH REQUIRES BIOPSY. BI-RADS 4: SUSPICIOUS RECOMMENDATION: Ultrasound guided biopsy left breast.
The Biopsy results were as such: Tubular Carcinoma, Grade 1. There is an in situ component composed of less than 10% of the tumor.
Final Assessment: Malignant, concordant.
Recommendation: MRI of the breast may be considered and surgical consultation for definitive treatment.
Anybody have experience with this type of diagnosis? The tumor is definitely small. I cannot discern if it's Pure or Mixed, but that "in situ of less than 10%" might mean it's pure. I have no idea of ER receptors, or any of that other stuff, but I am 61 and had a hysterectomy when I was 43. I take no hormone supplements.
I have an MRI (with dye) scheduled tomorrow and an appointment with a surgeon on Feb 26. I wonder if they do radiation, or hormonal or chemo with something so small? I would love some feedback from you all out there. I have never had cancer before. This is a new journey for me....I don't know the lingo, the meanings of things, etc. Thank you!
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sorry to hear you are joining us....that less than 10% in situ which means that along with the tubular invasive cancer, there is a little NON-invasive component to the tumor. Register at the NCCN's website and read the section on tubular and mucinous breast cancer treatment guidelines. The good news is that you have a small, "favorable" type of breast cancer that is very treatable. Once you have your final surgical pathology report, you and your team will then come up with a plan that will be right for you! Good luck!
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Hi Kaneli-
We want to welcome you to our community here at BCO. We're so sorry for the circumstances that have brought you here, but we're glad you've found us, and hope you find the support and advice you need moving forward.
You may also want to read through our forum for recently diagnosed members; you can find that forum here: https://community.breastcancer.org/forum/5. Some of the members there may be able to help you understand your pathology report and give you some advice and share their experiences regarding treatment. Good luck at your MRI tomorrow! We're all here for you!
The Mods
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Hi Kaneli,
I also had an invasive Tubular Carcinoma. We are actually fortunate to have a BC with such a positive prognosis. I'm sure you know this type is not likely to metastasis. I had two surgeries to remove the cancerous area....not a lump in my case...as I believe Tubular is not. They called the first surgery a lumpectomy and the second a partial mastectomy, done because they didn't have clear margins from the first surgery. I was very fortunate that things still look pretty normal other than being a bit smaller. Mine was located under my arm....about 6 inches from my underarm. I was given the option of radiation...which I took. I had 16 treatments. I was also offered tamoxifen but refused it as it was only going to give me a 1% risk reduction...or something like that. It is my 5th anniversary since my diagnosis in a few days! I was tested for the BRCA mutations because of my family history and was positive for BRCA2....so I receive high risk surveillance here in Canada.
Sorry you are joining us, but this site has tons of great information and support...Keep us posted as to your treatment decisions and progress.
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I had a 7 mm tumor of tubular BC treated with lumpectomy and a SNB. Even though no one expected to find any in my nodes because this seldom spreads, I did have one node positive found at surgery. My Oncotype was low (11) as would be typical for a tubular BC and so no chemo was recommended for me even with one positive node. Having an oncotype test done is I think really very important in determining whether or not you might benefit from chemo, just as having a SNB is important even though tubular seldom spreads-it's good to know. Due to mine being a tubular BC they expected me to have a low oncotype score, so there was no surprise there. Radiation is pretty much recommended for everyone if they choose a lumpectomy as I did. Lumpectomy and the recommendation of RADS seem to go hand in hand regardless of the tumor type and even without any positive nodes.
My oncologist recommended tamoxifen only due to my positive node. She said w a pure tubular BC tumor under 1 cm/10 mm she would not recommend it if no nodes had been involved.
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isee! Congrats on celebrating 5 years NED!!!😘
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THANKS voraciousre... !!!
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Yes, Isee, congratulations on 5 years! Voraciousreader and Labelle, thank you for your positive and encouraging words and for such quick responses to my post from a few hours earlier. I will keep checking on this great forum for answers and encouragement! My MRI is tomorrow morn, but I doubt I will have any info immediately after that but....Thank you all! It's nice to not feel so alone
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Kaneli- I also have pure Tubular. So far my treatment has been lumpectomy and now radiation starting next week for 15 treatments with one boost. I will not be taking hormones for the side affects are greater than the risk odds. My RO explained that there would be a 1% chance of a recurrence.
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Thanks Brightsocks! My MRI results came back this morning. The tumor appears to be "unilateral and unifocal' so that's good. It did mention a "slight asymmetry in size of a left axillary lymph node" (The same side as the tumor.) It went on to say it is "not a definitely abnormal lymph node" which kind of sounds like a double negative to me, so, I guess we'll have to see what the surgeon says. Maybe they'll want to take that lymph node when they do the lumpectomy. Anyway, I was happy they found nothing else. How did you do with the lumpectomy? Please keep me posted, since it seems like I'm right behind you on this.
Does anybody have experience with them taking the lymph node, or whatever it is that they do? Does that cause any unwanted side effects, of does it involve special risks? Thanks everyone....One week ago I was just a person who had 2 normal breasts....still getting my mind around this. BTW, what is a "Boost?" 0 -
Kaneli- I understand what you mean about how things change and now we are in the group looking for answers from new friends, medical teams and web searching treatments. I had a long talk with my RO about tubular BC with support information. If you do a web search you can find a study that was done by a creditable source on this type of cancer. One of my fears was what about over treatment? I feel I am doing the best I can without a fear of is there anything different I should try? He wrote out a odd chart to explain his point why I should have radiation how it improves my odds. I am still learning a ton of info by asking the ladies on the board and reading the web. Our type of BC is found only in 1 to 2% of cases.
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Has anyone gotten a 2nd opinion after their diagnosis of Tubular Carcinoma? If so, was it after the biopsy and MRI, but before surgery? I'm just wondering since it's a less common type of Breast cancer. I would imagine that after a biopsy, it either is cancer or is not....do I need someone else to look at those results?
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Can you tell me how they found yours? Was it a lump, or polyps etc.
Thank you
~Sunny sherri
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Hi Sunny, It was found on my 3D annual mammography. No lump, no symptoms.. The 3 D is a pretty new type of mammo, and my "lesion" is really small.....smaller than 1 cm. I don't know if they would have seen it with a traditional digital mammo. When they called me in for a 2nd mammo with "possible ultrasound', they did the ultrasound and right then and there they told me I needed a biopsy. 2 days later they told me it was Tubular Carcinoma. This was told to me on Wed, Feb 10, so I'm still reeling from it, and trying to research as much as I can. I have my first appointment with a (general) surgeon this Friday morning, and a 2nd opinion with a Breast surgeon who specializes in oncology on Monday. I know it's a small tumor, and that the prognosis appears to be very good, but, I am trying to be as thorough as possible. There's not a lot of info out there about Tubular Carcinoma. They say it's invasive, but slow....all of these seeming contradictions. Anyway, you can see I am frustrated, but I am happy to tell you what I learn after my surgeon appointments.
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Hi Sherri-lynn and Kaneli, my tubular carcinoma was found on a mammogram and then confirmed with an ultrasound and then a lumpectomy. Had radiation...they gave me the option of not doing them, but I thought it was less likely to come back after rads. I refused tamoxifin. I am BRCA2 + . I just had my 5 year NED anniversary
. If you're going to have breast cancer, apparently tubular carcinoma is the one to have! 1 -
Mine was seen on mammogram and ultrasound, but when they did ultrasound guided biopsy nothing was found, so they said it was discordant results (mammo and ultrasound did not match biopsy). They gave me three choices--wait 6 months, do the ultrasound guided biopsy again, or do an excisional biopsy. I chose the excisional, they got good margins so I didn't need any other lumpectomy although I did need to have a sentinal node biopsy. I had radiation and am now taking letrozole (I did have DCIS in other breast 2 years prior.)
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Thank you, Isee, for that encouraging info. 5 years NED is awesome! (Hate to tell you, but I'm not sure what NED means:) BookWoman, your story astonishes me! I can understand not wanting to wait another 6 months. And heck, if you're going to get a 2nd biopsy, you might as well have it excised. I definitely understand your logic. Did it turn out that the lumpectomy you had was indeed tubular cancer? How about your nodes?
I have my first surgeon apt tomorrow, (Fri 2/26/16). He's a general surgeon, Then a 2nd opinion with a breast oncology surgeon on Monday, the 29th. They both are recommended by my Mammo/Ultrasound/Biopsy/MRI/Primary Care Docs...so we shall see. I don't know if there will be decisions to be made, or if it's pretty straightforward. I'll post more later.
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NED means no evidence of disease
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Yes, it was tubular carcinoma and my nodes were clear. I had radiation and am now on letrozole.
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Just an update on my Tubular carcinoma. I am scheduled for a lumpectomy on Tuesday Mar 22nd. If my margins are clear, and there's no node involvement, I will go for the APBI (accelerated partial breast irradiation) that will be a course of treatment for 5 days, 2x a day. I will begin that the following Monday. The one I will have is called Contura. They will insert a balloon into the tumor cavity with multi catheters which will be like a port in my breast for those 5 days. I will go twice a day to the hospital where they will insert a radioactive pellet, or "seed" into the catheters which go into the balloon.The balloon is supposed to conform to the tumor cavity. The seeds stay in the balloon for a few minutes, until desired dose is reached, then withdrawn. It is an internal radiation that treats the local area of the tumor, from the inside, up to 1 cm into the borders. You have to be a "candidate" for this type of radiation, i.e, small, slow growing non-aggressive tumor, without expectation of node involvement. Also, over 60, I believe. These are characteristics of early stage Tubular Carcinoma. If there is node involvement, or other surprises after surgery, well, the plan will change, but hopefully this will go according to plan. After that, I believe I will have to do hormone therapy, probably an AI. I will cross that bridge when I get there. There's only so much a mind can absorb at once, so while I am thinking of the Hormone therapy and whether I want to do that, I need to get through this part first. I still have concerns about if this the right treatment for me, but when I think of the alternative of 6 weeks of WBI, I still feel that this is a better option for me. Has anybody else had experience with the type of radiation I'll be having?
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