What Is Invasive Ductal Carcinoma
Invasive ductal carcinoma begins when abnormal cells form in your milk ducts and spread to other parts of your breast tissue. Its the most common type of breast cancer, making up about 80% of all breast cancer cases. Invasive ductal carcinoma is also the type of breast cancer that most commonly affects men . This condition is sometimes called ductal carcinoma, infiltrating ductal carcinoma or IDC breast cancer.
How Is Ductal Carcinoma In Situ Treated
No two patients are the same. Your doctor will customize your treatment plan based on your test results and medical history. Among other things, your doctor will consider:
- Aggressiveness of the cancer cells
- Your family history of breast cancer
- Results of tests for a gene mutation that would increase the risk of breast cancer
Most women with DCIS don’t have the breast removed with a mastectomy. Instead, they have a lumpectomy.
Most common is a lumpectomy followed by radiation. The surgeon removes the cancer and a small area of healthy tissue around it. Lymph nodes under the arm donât need to be removed as they are with other types of breast cancer.
After a lumpectomy, radiation cuts the chances that the cancer will come back. If cancer does return, itâs called recurrence.
Some women may opt to have a lumpectomy only. Discuss the risks of not having radiation with your doctor before deciding against it.
You and your doctors may decide that a mastectomy to remove the breast is the best course of treatment if you have any of the following:
- A strong family history of breast cancer
- A gene mutation that makes having breast cancer more likely
- Very large areas of DCIS
- DCIS lesions in multiple areas throughout your breast
- Not being able tolerate radiation therapy
You and your treatment team may also consider the use of hormone therapy if the cancer tests positive for hormone receptors. It can cut the chance of getting another breast cancer.
Diagnosing Invasive Breast Cancer
In many people the cancer is found during breast screening.
Its important that you see your GP if you have any symptoms. They may refer you to a specialist breast clinic. At the breast clinic the doctor or specialist nurse takes your medical history and examines your breasts. They also feel for any swollen lymph nodes under your arms and at the base of your neck.
You may have some or all of the following tests:
- a biopsy a small sample of cells or tissue is taken from your breast and looked at under a microscope
Changes seen on the mammogram or ultrasound could be due to cancer, so you may have a biopsy of the breast. You might also have an ultrasound of the lymph nodes under your arm. You may also have lymph node biopsies if they look abnormal.
You should get your results within 1 or 2 weeks at a follow up appointment.
- drugs that help prevent or slow down bone thinning or bone damage
- a combination of these treatments
You may have surgery to your armpit called a sentinel lymph node biopsy. This means having about 3-5 lymph nodes removed. Sometimes surgeons have to remove more lymph nodes. Your doctor will let you know whether you need this.
You might have chemotherapy or hormone therapy before surgery called neoadjuvant therapy. The aim is to shrink the cancer down. This means that some people may be able to have breast conserving surgery, who might have needed removal of the breast .
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Clinical Trials Designed For Idc
Women with IDC may choose to enroll in a clinical trial to receive a new treatment thats not yet available to the general public.
Additionally, clinical trials help scientists determine if up-and-coming therapies are safe and effective.
Talk to your doctor about the benefits and risks of participating in a research study. You can also search for clinical trial near you at ClinicalTrials.gov, says Moffitt Cancer Center.
What Is Breast Cancer
This diagram of the breast shows the location of the lobules, lobe, duct, areola, nipple, and fat.
Breast cancer is a disease in which cells in the breast grow out of control. There are different kinds of breast cancer. The kind of breast cancer depends on which cells in the breast turn into cancer.
Breast cancer can begin in different parts of the breast. A breast is made up of three main parts: lobules, ducts, and connective tissue. The lobules are the glands that produce milk. The ducts are tubes that carry milk to the nipple. The connective tissue surrounds and holds everything together. Most breast cancers begin in the ducts or lobules.
Breast cancer can spread outside the breast through blood vessels and lymph vessels. When breast cancer spreads to other parts of the body, it is said to have metastasized.
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Invasive Ductal Carcinoma Survival Rate
A five-year survival rate refers to the percentage of cancer patients who are alive five years after they were diagnosed. Keep in mind that these are estimates and based on past data, and advances in treatments may have improved these numbers.
If cancer is limited to the breast, the five-year survival rate estimate is 99 percent, according to the American Society of Clinical Oncology , and a majority of women with breast cancer receive a diagnosis at this stage.
If cancer has spread to the neighboring lymph nodes, the five-year survival rate is 86 percent, according to the ASCO, and if its spread to a distant part of the body , the rate is 28 percent.
Tremendous strides in treating breast cancer, as well as diagnosing it earlier when its in more treatable stages, are helping to improve these statistics.
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What Are The Stages Of Invasive Ductal Carcinoma
Invasive ductal carcinoma is usually described through a numeric scale ranging from 1 to 4 . Specifically, the invasive ductal carcinoma stages are:
- Stage 1 A breast tumor is smaller than 2 centimeters in diameter and the cancer has not spread beyond the breast.
- Stage 2 A breast tumor measures 2 to 4 centimeters in diameter or cancerous cells have spread to the lymph nodes in the underarm area.
- Stage 3 More extensive cancer is found, but it is confined to the breast, surrounding tissues and lymph nodes.
- Stage 4 The breast cancer has metastasized to lymph nodes beyond the underarm area or to distant sites, such as the lungs, liver, bones or brain.
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Symptoms Of Invasive Ductal Carcinoma
While there are some signs and symptoms of IDC to look out for, its important to remember that, like with any breast cancer, some women particularly those in the early stages may not notice any symptoms at all. The cancer may be first discovered on a routinemammogram before any symptoms are noticed, making regular check-ups all the more essential. However, there are some potential signs of IDC to look out for, including:
- changes in the breast shape
- breast or nipple pain
- thickening of the nipple skin
If you notice any unusual changes in your breasts, its important to see a doctor as soon as you can.
Treatment For Early And Locally Advanced Invasive Breast Cancers
Treatment for early and locally advanced invasive breast cancer includes some combination of surgery, radiation therapy, chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies.
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How Long Does It Take To Recover From Invasive Ductal Carcinoma Treatment
People who undergo surgery for invasive ductal carcinoma usually recover in about two to four weeks. Healing may take longer if lymph nodes are removed or if you choose to undergo breast reconstruction.
Recovery after chemotherapy, radiation therapy, targeted therapy or immunotherapy may take several weeks or several months, depending on the location and stage of the tumor. Your healthcare provider can tell you about how long your treatment should take.
Subtypes Of Invasive Ductal Carcinoma
IDC can appear in several different ways under a microscope. A biopsy will help your doctor understand which subtype of IDC you have.
About 70 percent of IDC cases are classified as no special type . But when the cancer cells have special features, they may be classified as one of the following:
Your breast cancer may be a combination of some of the subtypes listed above.
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Treating Invasive Breast Cancer
Treatment of invasive breast cancer depends on how advanced the cancer is and other factors. Most women will have some type of surgery to remove the tumor. Depending on the type of breast cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.
See Treating Breast Cancer for details on different types of treatment, as well as common treatment approaches based on the stage or other factors.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Arpino G, Infiltrating lobular carcinoma of the breast:tumor board characteristics and clinical outcome. Breast Cancer Research. 2004 6: 149.
Dillon DA, Guidi AJ, Schnitt SJ. Ch. 25: Pathology of invasive breast cancer. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 5th ed. Philadelphia, Pa: Lippincott-Williams & Wilkins 2014.
Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Chapter 88: Cancer of the Breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloffs Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier 2020.
Huober J, Gelber S, Goldhirsch A, et al. Prognosis of medullary breast cancer: analysis of 13 International Breast Cancer Study Group trials. Ann Oncol. 2012 23:28432851.
Invasive Ductal Carcinoma Prognosis
So is invasive ductal carcinoma curable? The linguistics of the word curable are not black and white. In this case, we will assume that curable means that there is no remaining evidence of disease. The short answer, then, is that IDC can be curable with the correct treatment methods. Treatment will be determined based on the stage of IDC, which classifies the size and location of the cancerous cells. The provider will analyze the growth and spread of the lump throughout the body to determine this. IDC consists of four stages. Stage 1 means that the tumor is smaller than 2 centimeters in diameter and the breast cancer is contained to just the breast. Stage 2 is a smaller lump that has only spread to a few lymph nodes in the underarm area while Stages 3-4 refer to a larger lump that has spread to multiple lymph nodes or other organs. The 5-year survival rate of Localized IDC is 99% while Regional IDC is 86% and Distant IDC is 27%. With IDC, there are usually strong positive prognoses, although as with any medical procedure, it is impossible to guarantee a 100% success rate.
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What Is Stage 0 Breast Cancer
Stage 0 breast cancer. Stage 0 breast cancer, or ductal carcinoma in situ , is when there are atypical cells in the lining of your milk ducts. But those cells have not spread beyond the wall of the duct to reach surrounding tissue, your bloodstream, or lymph nodes. DCIS is noninvasive and is sometimes called precancer..
Risk Factors For Invasive Ductal Carcinoma
Age and gender are the two greatest risk factors for developing invasive ductal carcinoma. Women over the age of 55 are more likely to develop invasive breast cancer than any other group of people.
Some other risk factors that doctors have identified are:
- Weight weight gain and obesity in adulthood play a role due to changes in hormones.
- Breast tissue women with less fatty tissue in their breasts have an increased risk of the disease.
- Family history those with family members who also had breast cancer are more likely to develop the disease.
- No children women who have never had children are at increased risk. At the same time, women who breastfeed reduce their risk of developing breast cancer.
- Genetic mutations mutations in the BRCA1 and BRCA2 genes are the most common causes of invasive breast cancer.
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Hormone Therapy After Breast Surgery
If the DCIS is hormone receptor-positive , treatment with tamoxifen or an aromatase inhibitor, such as exemestane or anastrozole, for 5 years after surgery can lower the risk of another DCIS or invasive cancer developing in either breast. If you have hormone receptor-positive DCIS, discuss the reasons for and against hormone therapy with your doctor.
How To Diagnose Cancer
Biopsy is the only way to diagnose cancer. For this, the doctor will use a needle to remove a tissue sample. A pathologist will examine the tissue under a microscope and provide a report to your doctor. The pathology report will say whether there are atypical cells present and, if so, how aggressive they may be.
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What You Need To Know
- The risk of getting invasive ductal breast cancer increases with age: According to the American Cancer Society, about two-thirds of women diagnosed with IDC are age 55 or older.
- IDC can affect men.
- Without prompt treatment, invasive ductal carcinoma can spread to lymph nodes or blood vessels and metastasize throughout the body.
- Identifying characteristics of the tumor, such as whether or not the cells are sensitive to certain hormones, can help your doctor choose the best treatment.
Surgery For Invasive Ductal Carcinoma
Breast cancer treatment has evolved to offer patients more options. In addition to removing breast cancer, new aesthetic surgical approaches can enhance well-being and lessen the emotional impact of losing all or part of a breast to cancer. Comprehensive breast centers with coordinated teams of oncologic and plastic surgery practitioners can offer a wider array of options.
Surgery for IDC may include one of these procedures:
- Lumpectomy is removal of part of the breast. It is also known as breast-conserving surgery. Lumpectomy may be followed by radiation treatments to treat any remaining cancer cells.
- Mastectomy is removal of the breast. Mastectomy is a treatment for patients with multiple, very aggressive, or large invasive ductal tumors. It can be followed by breast reconstruction.
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Checking For Ductal Breast Cancer In Lymph Nodes
The goal of invasive ductal carcinoma treatment is to get the cancer out of the breast. But we also may need to remove lymph nodes if the cancer has spread there, Wright explains.
Your lymph nodes are part of your immune system. Lymph fluid from the breast drains into the axillary lymph nodes. The number and location of axillary lymph nodes may be different from person to person.
A sentinel lymph node biopsy is a test that can help your doctor determine if removing lymph nodes may be part of your cancer surgery.
The sentinel lymph node is where cancer from invasive ductal carcinoma is likely to show up first. Your doctor can identify the sentinel lymph node by injecting dye into the breast and seeing which node takes up the dye first: This is the sentinel. A sample of tissue from this node can reveal if cancer has spread there.
If theres no cancer in the sentinel node, the other nodes are OK and dont need to be removed, says Wright. If theres a small amount of cancer present, well leave nodes in place and treat the area with radiation or use chemotherapy.
If we see a lot of cancer in the lymph nodes or if four or more lymph nodes are affected, we perform an axillary lymph node dissection: surgery to remove the nodes.
Treatment For Invasive Ductal Carcinoma
There are several different options which may be recommended to treat IDC. A decision on what treatments are recommended for any individual are made by the treating team . Below are some of these options:
Surgery is often recommended as the first stage in the treatment forthe earlier stages of IDC but is not usually recommended for women with metastatic IDC. Depending on the stage of the tumour at diagnosis , surgery can take the form of either breast conserving surgery where the breast cancer is removed and a small amount of healthy breast tissue or alternatively a mastectomy, which is the removal of the entire breast. During both types of surgeries, some women will also have one or more lymph nodes from the armpit removed.
Radiation therapy involves the delivery of high energy and ionising radiation to the affected area in the breast. Some women may also have radiotherapy on their underarm area. Radiotherapy is almost always recommended after breast conserving surgery such as a lumpectomy, to target any remaining cancer cells. Radiotherapy is sometimes recommended after a mastectomy. Radiotherapy may also be used for women with metastatic breast cancer to manage pain, relieve symptoms, prevent fractures and treat the cancer that has spread to other parts of the body .
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How Is Invasive Ductal Carcinoma Diagnosed
Your healthcare provider will perform a physical examination. In addition to feeling for lumps in your breast, they may also feel for swollen lymph nodes in your underarm area.
In most cases, invasive ductal carcinoma is found during routine mammograms. If your healthcare provider thinks you may have IDC, they may order other tests, including:
- Magnetic resonance imaging . This imaging test uses radio waves and magnets to produce detailed pictures of your breast tissue.
- Ultrasound. Using high-frequency sound waves, an ultrasound provides clear images of your internal organs and other tissues.
- Biopsy. Your healthcare provider takes a small sample of your breast tissue with a needle. The sample is then sent to a pathology lab for further testing.