Tubular breast carcinoma is a rare subtype of breast cancer that represents around 1-4% of all cases of invasive breast carcinoma. Protheragen offers integrated diagnostic and therapeutic development solutions for tubular breast carcinoma. These include diagnostics at the histopathological and molecular levels, imaging diagnostics, drug development and preclinical studies, as well as comprehensive drug discovery programs.
Overview of Tubular Breast Carcinoma
Well-differentiated tubular structures and an excellent prognosis characterize tubular breast carcinoma as a rare subtype of invasive breast carcinoma. It constitutes a grade 1 (G1) tumor in the Elston-Ellis classification with antenatal tubal branching associated with elevated estrogen receptor (ER) and progesterone receptor (PR) activity, but no HER2 overexpression. Tubular breast carcinoma accounts for approximately 1%-4% of all invasive breast cancers and is detected in postmenopausal women as small, often asymptomatic lesions. Its histological features include tubules with open lumina lined by a single layer of epithelial cells, interspersed with dense fibrous stroma. The low Ki-67 proliferation index and absence of significant nuclear atypia contribute to its favorable clinical outcome.
Fig.1 A case of tubular breast carcinoma composed of well-differentiated rounded to angulated tubular structures organized haphazardly. (Metovic J.,
et al., 2021)
Pathogenesis of Tubular Breast Carcinoma
The pathogenesis of tubular breast carcinoma is multifactorial combining genetic and histological features. It displays a low proliferative index (Ki-67) which corresponds to low cell growth, and is almost always negative for HER2, PR and ER overexpression. Other low-grade breast lesions also have 16q deletions and these appear to be common in tubular breast carcinoma. Histologically, tubular breast carcinoma is characterized by the presence of well differentiated closed tubules which are devoid of significant cytological atypia, containing dense fibrous stroma within the interstitium, and the lack of myoepithelial cells encasing the tubules. There is molecular evidence suggesting that flat epithelial atypia together with low grade DCIS could be antecedent lesions for tubular breast carcinoma.
Diagnostics Development for Tubular Breast Carcinoma
- Histopathological Diagnostics
Tubular breast carcinoma diagnosis verification requires a histopathological study as an integral step. Distinctively, the tumor comprises of well well-differentiated tubular structures with open lumina containing a single epithelial cell layer, and is surrounded by dense fibrous stroma. Tumors of this type typically demonstrate greater expression of estrogen and progesterone receptors while showing lower levels of HER2 receptors which is characteristic of this type of tumor. In addition, expression of Ki-67 at low levels further substantiates the diagnosis of indolent tubular breast carcinoma.
- Molecular Diagnostics
The study of molecular diagnostics comprises evaluating genetic mutations alongside changes within specific biomarkers, also known as biomarkers. Tubular types of breast carcinoma typically show low proliferative rates and diploid karyotypes, which are marked by 16q deletions. Next-generation sequencing (NGS) has provided further capabilities through the ability to find distinct genetic variants along with other alterations and lesions. Such discoveries can lead to understanding the pathogenesis of the illness and assist in determining targeted therapy strategies.
Therapeutics Development for Tubular Breast Carcinoma
- Hormonal Therapy
Due to the tumor's elevated ER and PR expression levels, hormonal therapy remains one of the essential therapeutic methods for tubular breast carcinoma. For larger lesions or those with lymph node involvement, Tamoxifen or aromatase inhibitors may be preferred. Hormonal therapy enhances the prognosis and mitigates the risk of recurrence.
- Targeted Therapies
Because of the low incidence of HER2 overexpression in tubular breast carcinoma, trastuzumab and other targeted therapies are not routinely employed. Nevertheless, other research is analyzing the possible advantages of targeted therapies for particular molecular subclasses of tubular breast carcinoma.
Table 1. Therapeutics of tubular breast carcinoma.
| Drug Name |
Target |
Description |
Stage |
| Anthracyclines, Taxanes |
Cancer cells |
Adjuvant chemotherapy (e.g., anthracyclines, taxanes) to reduce the risk of recurrence. Neoadjuvant chemotherapy to shrink the tumor before surgery. |
Approved |
| Tamoxifen, Aromatase Inhibitors |
Estrogen receptor (ER) |
Tamoxifen or aromatase inhibitors (e.g., anastrozole, letrozole) for ER-positive tumors. Used for 5-10 years to reduce the risk of recurrence. |
Approved |
| Trastuzumab (Herceptin) |
HER2 receptor |
For HER2-positive tumors, used in combination with chemotherapy. Reduces the risk of recurrence and improves survival. |
Approved |
| Ado-trastuzumab emtansine (T-DM1, Kadcyla) |
HER2 receptor |
Antibody-drug conjugate combining trastuzumab with the chemotherapy agent emtansine. Approved for metastatic HER2-positive breast cancer. |
Approved |
| Neratinib (Nerlynx) |
HER family (EGFR/HER1, HER2, HER4) |
Irreversible pan-tyrosine kinase inhibitor. Used for extended adjuvant treatment in HER2-positive breast cancer. |
Approved |
| Trastuzumab-deruxtecan (DS-8201a, Enhertu) |
HER2 receptor |
Novel antibody-drug conjugate with a higher drug-to-antibody ratio. Approved for metastatic HER2-positive breast cancer. |
Approved |
| Pertuzumab (Perjeta) |
HER2 receptor |
HER2/3 heterodimerization inhibitor. Used in combination with trastuzumab and chemotherapy for metastatic HER2-positive breast cancer. |
Approved |
| Margetuximab |
HER2 receptor |
Monoclonal antibody with an engineered Fc region to enhance immune response. Demonstrated improved progression-free survival in the SOPHIA trial. |
Phase III |
| Tucatinib (ONT-380) |
HER2 receptor |
Oral selective HER2 tyrosine kinase inhibitor. Showed promising results in combination with trastuzumab and capecitabine in metastatic HER2-positive breast cancer. |
Phase II/III |
| Pyrotinib |
HER family (HER1, HER2, HER4) |
Irreversible pan-tyrosine kinase inhibitor. Conditionally approved in China for HER2-positive metastatic breast cancer. |
Phase II/III |
Disclaimer: Protheragen focuses on providing preclinical research services. This table is for information exchange purposes only. This table is not a treatment plan recommendation. For guidance on treatment options, please visit a regular hospital.
Our Services
Protheragen offers comprehensive diagnostics and therapeutics development services for tubular breast carcinoma. Our services include advanced histopathological diagnostics, molecular testing, and the development of targeted therapies.
Diagnostics Development
- Karyotype Analysis Service
- Omics Analysis Service
- Biomarker Development Service
- Artificial Intelligence Service
- Customized Diagnostics Development
Therapeutic Development
- Anticancer Peptide
- Gene Therapy
- Immunotherapy
- Monoclonal Antibody
- Phytotherapy
- Small Molecule Drug
- Therapeutic Cancer Vaccine
Disease Models
- 2D and 3D Cell Culture Models
- Patient-Derived Organoids
- Genetically Engineered Organoids
- MCF-7, MDA-MB-231, and BT474 Xenograft Models
Protheragen's
preclinical research services for tubular breast carcinoma focus on understanding the disease's molecular mechanisms and developing effective therapies. Our services include high-throughput screening of potential therapeutic compounds, in vitro and in vivo efficacy studies, and translational research to bridge the gap between bench and bedside. If you are interested in our services, please feel free to
contact us.
References
- Metovic, Jasna, et al. "Clinical relevance of tubular breast carcinoma: large retrospective study and meta-analysis." Frontiers in Oncology 11 (2021): 653388.
- Zhang, Tianzhi, et al. "Tubular Carcinoma of the Breast: A Clinicopathological Analysis of Two Cases." Advances in Bioscience and Biotechnology 13.11 (2022): 499-506.
All of our services and products are intended for preclinical research use only and cannot be used to diagnose, treat or manage patients.
