Surgical Pathology Criteria

Tubular Carcinoma of the Breast

Differential Diagnosis

Tubular Carcinoma Sclerosing Adenosis
Stellate, infiltrating Circumscribed, nodular
Patent ducts, gaping lumens Many ducts have obliterated lumens
Minimal branching Frequent branching
Single layer of cells Sometimes more than one layer of cells
Cells polarized to lumen Cells smaller, streaming
Myoepithelial cell absent Myoepithelial cells present

Tubular Carcinoma Microglandular Adenosis
Stellate, infiltrating Nodular or diffuse
Round to oval ducts with pointed ends and gaping lumens Uniform small round ducts with small lumens
Frequent apical snouts No apical snouts
Empty lumens Eosinophilic secretion present in at least some lumens
Larger cells, polarized to lumen Cells smaller, flatter
Round nuclei Nuclei may be flat, parallel to base
EMA positive EMA negative
Basement membrane absent Basement membrane variable
Both have rounded non-branching ducts with a single layer of cells, lacking myoepithelial cells

Tubular Carcinoma Tubular Adenosis
Stellate, infiltrating Diffuse
Frequent apical snouts No apical snouts
Ducts with frequent pointed ends Infrequent pointed ends
Empty lumens Eosinophilic secretion present in at least some lumens
Stroma desmoplastic Stroma usually hypocellular or fat
No myoepithelial cells Myoepithelial cells

Tubular Carcinoma Radial Scar
Single layer of cells Often multiple cell layers
No myoepithelial cells Myoepithelial cells present
Frequent infiltration of fat by naked tubules No bare infiltration of fat
No epithelial hyperplasia May show epithelial hyperplasia
Both have a stellate configuration with radiating fibrous arms and fibroelastotic stroma

Tubular Carcinoma Grade I Infiltrating Ductal Carcinoma, NOS
Stellate infiltration Irregular infiltration
90% tubules May have >10% ribbons or cords
Infrequent branching Frequent budding and branching
Single layer of cells May show stratification
Uniform chromatin Slightly irregular chromatin
Nucleoli inconspicuous Nucleoli may be prominent
  • A continuum exists between tubular carcinoma and well differentiated (Grade I) infiltrating ductal carcinoma
  • It is probable that a small (under 2.0 cm) well differentiated infiltrating ductal carcinoma will have a prognosis similar to that of tubular carcinoma so the distinction may not be critical
  • Grade II and III carcinomas are excluded by definition from tubular carcinoma.
  • Tubular Carcinoma Tubulolobular Carcinoma
    90% pure tubular pattern Mixed tubular and lobular patterns
    Stellate infiltrating architecture Linear infiltrative pattern, frequently concentric
    Both are typically E-cadherin positive

    Tubular Carcinoma vs Cribriform Carcinoma

    Tubular Carcinoma Low Grade Adenosquamous Carcinoma
    Uniform, gaping tubules Irregular, frequently compressed lumens
    Tubules frequently have pointed ends Tubules frequently have long comma-shaped tails
    No squamous differentiation At least focal squamous differentiation
    No myoepithelial component Myoepithelial cells prominently present around tubules
    Both are low grade cytologically and clinically

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