Background Breast tubular adenoma is a rare, benign epithelial tumor that can mimic fibroadenoma on clinical and radiological assessment, creating diagnostic and management uncertainty. This case series describes the clinical, radiological, and histopathological features of tubular adenoma across a broad age range and reviews management strategies. Method A retrospective review was performed on six female patients aged 22-62 years diagnosed with breast tubular adenoma. Data collected included clinical presentation, breast cancer risk factors, imaging characteristics and BI-RADS classification, histopathological findings from core and excisional biopsies, management decisions, and follow-up outcomes. All diagnoses were histologically confirmed, with radiological surveillance ranging from 5 to 18 months where applicable. All diagnoses were histologically confirmed, with radiological surveillance ranging from 5 to 18 months where applicable. Results Patients presented with either incidental imaging findings or palpable breast masses, and five had risk factors for breast cancer. Ultrasound appearances were variable, most commonly well-circumscribed hypoechoic lesions, with some demonstrating internal vascularity, resulting in BI-RADS 2-4 assessments. Histopathology consistently showed small, uniform, closely packed round tubules lined by an inner layer of luminal epithelial cells and an outer layer of myoepithelial cells with sparse fibrovascular stroma intervening tubules and occasional luminal eosinophilic secretion, confirming tubular adenoma. Two patients were managed conservatively with imaging surveillance, while four underwent excisional biopsy due to symptoms, patient preference, radiological uncertainty, or significant family history. No malignant features, and in up to 18 months follow-up, interval progression, transformation or post-excision recurrences were identified. Conclusion Tubular adenoma of the breast is a rare benign lesion with significant overlap with fibroadenoma, and occasional radiological concern for malignancy. Histopathological confirmation is essential. This series demonstrates the outcomes with both surveillance and surgical excision when management is guided by radiologic-pathologic concordance, patient risk factors, and clinical preference.