Invasive Ductal Carcinoma

What is invasive ductal carcinoma?

Invasive ductal carcinoma (IDC) accounts for about 80% of all breast cancer cases in women and people assigned female at birth (AFAB). It typically affects women and people AFAB age 55 and older. It’s also the most common male breast cancer. This article focuses on IDC affecting women and people AFAB.

Invasive ductal carcinoma starts in cells that line the milk ducts in your breast. It can spread from your milk duct to surrounding breast tissue. From there, the cancer can get into your bloodstream or lymphatic system and spread to other areas of your body.

Healthcare providers may use names like ductal carcinoma, infiltrating ductal carcinoma or IDC breast cancer when they talk about this condition. Often, healthcare providers can cure it if tests detect cancerous tumors before they spread to other areas of your body.

Types of invasive ductal carcinoma

IDC types reflect the tumors’ hormone receptor status. Receptors are protein molecules in or on cells’ surfaces. They can attract or attach to certain substances in your blood, including hormones like estrogen and progesterone that help cancerous tumors to grow. Knowing a breast cancer tumor’s hormone receptor status helps providers decide which treatment will be most effective.

Common types of invasive ductal carcinoma are:

• Triple-negative breast cancer.
• HER2-positive (HER2+) breast cancer.
• ER-positive (ER+) breast cancer.
• PR-positive (PR+) breast cancer.

What are the symptoms of invasive ductal carcinoma (IDC)?

Often, routine mammograms detect invasive ductal carcinoma before you have noticeable symptoms. When IDC symptoms do appear, they may include:

• A change in the size, shape or contour of your breast.
• A mass or lump, which may feel as small as a pea.
• A lump or thickening in or near your breast or in your underarm that persists through your menstrual cycle.
• A change in the look or feel of your skin on your breast or nipple. Your skin may look dimpled, puckered, scaly or inflamed and reddened.
• A marble-like hardened area under your skin.
• A blood-stained or clear fluid discharge from your nipple.

What causes invasive ductal carcinoma?

Experts don’t know the exact cause, but they believe the following activities or experiences may increase your risk of developing invasive ductal carcinoma:

• Smoking.
• Consuming beverages containing alcohol.
• Having obesity.
• Having had radiation therapy to your chest area.
• Starting your menstrual cycle earlier or later than usual.
• Having children later in life.

Certain inherited genetic mutations may increase your risk of developing invasive ductal carcinoma. An inherited genetic mutation is an abnormal gene or genes that you inherit from your biological parents.

What are complications of this condition?

Invasive ductal carcinoma can spread (metastasize) to other areas of your body, including your liver, lungs, bones and brain.

How is invasive ductal carcinoma diagnosed?

A healthcare provider will perform a physical examination. They’ll check for lumps in your breasts. They may also check for swollen lymph nodes in your armpit. They may order other tests, including:

• Breast MRI.
• Breast ultrasound.
• Breast biopsy.

An oncologist and a cancer care team will use test results to plan your treatment. They do that by identifying the cancer stage and grade.

Stages of IDC

Healthcare providers base cancer stage on factors, like the tumor’s location and size. There are five stages of invasive ductal carcinoma:

• Stage 0: The cancer is localized to your milk ducts. This stage is also known as noninvasive ductal carcinoma in situ.
• Stage I (1): The cancer has spread outside of your milk ducts to your breast tissue, but it hasn’t spread to your lymph nodes. In some cases, cancer may be in your lymph nodes but not in surrounding breast tissue.
• Stage II (2): You have a small tumor that’s in one to three of your lymph nodes. A large tumor that hasn’t spread to lymph nodes is also a Stage II IDC.
• Stage III (3): There’s cancer in more than three of your lymph nodes. Cancer that causes breast skin inflammation is also a Stage III invasive ductal carcinoma.
• Stage IV (4): Invasive ductal carcinoma is in other organs like your liver, lungs, brain or chest wall. It may be in your bones or lymph nodes in more distant parts of your body.

Grades of IDC

Cancer cell grades are based on how much the cancerous cells look like normal cells when viewed under a microscope. When medical pathologists set cancer cell grades, they examine three parts, or aspects, of the cell and give each aspect or part a grade. Sometimes, pathologists use the terms “well-differentiated,” “moderately differentiated” or “poorly differentiated” instead of a number. The three grades are:

• Grade 1 (well-differentiated): The cancerous cells are growing slowly and look more like noncancerous breast cells.
• Grade 2 (moderately differentiated): The cells are growing faster than Grade 1 cells and look more like cancerous cells than noncancerous cells.
• Grade 3 (poorly differentiated): The cells look very different from noncancerous cells and are likely to grow and spread more quickly than Grade 1 and Grade 2 cells.

How is invasive ductal carcinoma treated?

Treatment options vary depending on your situation, including cancer stage and your personal preferences. IDC treatments may include:

• Breast cancer surgery: If you have surgery, it may be a lumpectomy or a mastectomy. Breast cancer surgery may involve breast reconstruction.
• Chemotherapy: Providers may do chemotherapy before surgery to shrink the tumor or after surgery to kill any remaining cancer cells that could be in your body. It may be your main treatment if you have metastatic (Stage IV) invasive ductal carcinoma.
• Radiation therapy: If you have surgery, you may have this treatment after to kill any remaining cancerous cells. This treatment may also be an option if surgery isn’t an option due to tumor size or location.
• Targeted therapy: This cancer treatment targets the genetic changes that turn healthy cells into cancerous cells.
• Hormone therapy: Cancer cells often need access to hormones to grow and multiply. Hormone therapy cuts off that access.
• Immunotherapy: Immunotherapy helps your immune system find and destroy cancerous cells.

What are treatment side effects?

Surgery is a common treatment for invasive ductal carcinoma. Pain after surgery is a common side effect. Providers may combine surgery with other treatments, too. Common chemotherapy and radiation therapy side effects include fatigue or nausea and vomiting.

Targeted therapy and immunotherapy have similar side effects like gastrointestinal issues, such as constipation and diarrhea. Hormone therapy side effects include hot flashes, joint pain and loss of interest in sex.

People react differently to breast cancer treatments. If you’re receiving treatment, ask your healthcare provider how treatment may affect you, including how it may affect your daily life. Ask your provider about palliative care, too. Palliative care helps manage breast cancer symptoms and treatment side effects so you’re as comfortable as possible as you go through treatment.

Can invasive ductal carcinoma be prevented?

No, it can’t, but you can take steps to reduce the chance you’ll develop invasive ductal carcinoma:

• Have regular mammograms. If you’re a woman or person AFAB and have a family history of breast cancer, ask a healthcare provider if you should start having mammograms earlier than most people.
• Eat a well-balanced diet that helps you maintain a weight that’s right for you.
• Don’t smoke.
• Limit beverages containing alcohol to one drink a day.
• Exercise regularly.
• Talk to a healthcare provider about tests to detect genetic mutations that increase your risk of developing breast cancer.

How long can you live with invasive breast cancer?

Survival rates for invasive ductal carcinoma are estimates based on the experiences of people who have it. The National Cancer Institute collects invasive ductal carcinoma rates by stages: local, regional and distant.

As you think about breast cancer survival rates, remember that they’re only estimates based on other people’s experiences. Cancer affects different people in different ways. If you have specific questions about cancer survival rates, talk to your healthcare provider. They’re your best resource because they know your situation.

How do I take care of myself?

Living with invasive ductal carcinoma (IDC) may not be easy. You may have days when you feel overwhelmed by your situation. Consider the following suggestions for taking care of yourself as you go through diagnosis and treatment for IDC:

• Get enough rest. IDC and treatment can be exhausting. Try to remember to rest when you need to, not just when you can.
• Eat well. Treatment may affect your appetite. A diet of fruit, vegetables, lean protein and healthy grains can help you stay strong during treatment.
• Manage your stress. Cancer is stressful. Exercise can help, from regular walks to exercise programs.
• Find support. You’re a breast cancer survivor starting the day you receive your diagnosis. Ask your healthcare provider about cancer survivorship programs, which may help you manage some of the challenges that come with living with IDC.

When should I see my healthcare provider?

Contact your provider if you have symptoms that may be signs that invasive ductal carcinoma is spreading from your milk ducts to your breast tissue, to nearby lymph nodes or other areas of your body. Metastatic IDC symptoms may include:

• New lumps in your breast.
• Swollen lymph nodes in your armpit.
• Chest pain.
• Shortness of breath (dyspnea).
• Bone pain.
• Belly pain.
• Confusion.

When should I go to the emergency room?

Go to the ER if you’re receiving treatment and have side effects that are more intense than you anticipated. You should also go to the ER if you have chills or a fever that’s 104 degrees Fahrenheit (38 degrees Celsius) or higher. A high fever and chills may be symptoms of infection.

What questions should I ask my healthcare provider?

Asking questions so you understand your situation is one of the best ways you can take care of your health. Consider asking the following questions about invasive ductal carcinoma:

• Where is the tumor?
• How big is the tumor?
• What’s the tumor’s hormone status?
• What are potential treatments?
• How will treatments affect my daily life?
• What are survival rate estimates?

What is the most aggressive form of breast cancer?

The most aggressive form of breast cancer is metastatic breast cancer. This means that the cancer has spread from your breast tissue to distant areas of your body.

What is triple-negative invasive ductal carcinoma?

Triple-negative breast cancer makes up about 15% of all breast cancers. In these cases, the cancer cells don’t have estrogen or progesterone receptors. They also don’t make much of the HER2 protein. Triple-negative invasive ductal carcinomas grow and spread faster than other types of breast cancer. The main treatment for this type of breast cancer is chemotherapy. Immunotherapy is added to chemotherapy for certain patients with this type of breast cancer.

A note from Cleveland Clinic

Hearing that you’ve been diagnosed with breast cancer can be shocking, saddening and frustrating. You may want to consider joining a support group for people with breast cancer. Spending time with others who are going through the same thing can be beneficial for your mental, emotional and spiritual health. Invasive ductal carcinoma can be successfully treated, especially when detected early. So, call your healthcare provider right away if you notice any worrisome symptoms. Prompt treatment can help you improve your overall quality of life.