Invasive (Infiltrating) Ductal Carcinoma

Overview

What is invasive ductal carcinoma?

Invasive ductal carcinoma (IDC) begins when abnormal cells form in your milk ducts and spread to other parts of your breast tissue. It’s 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 (male breast cancer). This condition is sometimes called ductal carcinoma, infiltrating ductal carcinoma or IDC breast cancer.

What’s the difference between invasive ductal carcinoma and ductal carcinoma in situ?

Ductal carcinoma in situ (DCIS) means that the cancer cells are still contained in your milk ducts. Invasive ductal carcinoma (IDC) means that the cancer has begun to spread to (or invade) your surrounding breast tissue.

Who does invasive ductal carcinoma affect?

Invasive ductal carcinoma can affect both men and women. It’s more common in people over 55, but it can occur at any age. Transwomen have a higher risk of developing breast cancer compared to cisgender men, while transmen have a lower risk of developing breast cancer compared to cisgender women.

How common is invasive ductal carcinoma?

This type of breast cancer is extremely common. Approximately eight out of 10 breast cancers are diagnosed as invasive ductal carcinomas.

What can you tell me about invasive ductal carcinoma stages?

Staging describes how advanced your cancer is, based on the location, size and how far it has spread. There are five stages of ductal carcinoma:

  • Stage 0: The cancer is localized to your milk ducts. This stage is also known as non-invasive ductal carcinoma in situ.
  • Stage 1: The cancer has spread outside of your milk ducts to the breast tissue, but it hasn’t spread to your lymph nodes. In some cases, the cancer may have spread to your lymph nodes, but not to your surrounding breast tissue.
  • Stage 2: The tumor is small and has spread to one to three of your lymph nodes. Or, the tumor is larger, but hasn’t spread to any of your lymph nodes.
  • Stage 3: The cancer has often spread to more than three of your lymph nodes or is causing inflammation of most of your breast skin, but hasn’t spread to other areas of your body.
  • Stage 4: The cancer has spread to your other organs, which may include your bones, liver, lungs, brain, chest wall or distant lymph nodes.

Symptoms and Causes

What are the symptoms of invasive ductal carcinoma?

In the early stages, invasive ductal carcinoma may not cause any obvious symptoms. Some people may develop certain warning signs, including:

  • A new lump in the breast.
  • Swelling of the breast.
  • Breast pain (mastalgia).
  • Nipple pain.
  • Dimpling.
  • Skin irritation.
  • Redness or scaliness.
  • A lump near the armpit.
  • Inverted nipple.
  • Thickening of the breast skin or nipple.
  • Discharge from the nipple that isn’t breast milk.

What causes invasive ductal carcinoma?

Experts don’t fully understand what causes invasive ductal carcinoma. Certain risk factors have been identified, however. These include:

  • Smoking.
  • Alcohol use.
  • Being overweight.
  • Prior radiation to the chest.
  • Early start of menstrual periods.
  • Late menopause.
  • Never being pregnant or having children later in life.

In approximately 5% to 10% of breast cancer cases, invasive ductal carcinoma has been linked to hereditary factors. These include mutations of the breast cancer gene 1 (BRCA1), breast cancer gene 2 (BRCA2) and other genes such as PALB2, CHEK2 and ATM.

How does invasive ductal carcinoma spread?

As the terms “invasive” and “infiltrating” suggest, the cancer has already spread to your surrounding breast tissues at the time of diagnosis. Eventually, it can spread to your lymph nodes, through your blood and other areas of your body, including your liver, lungs, bone and brain.

Diagnosis and Tests

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. (That’s why regular screenings are so important.) If your healthcare provider thinks you may have IDC, they may order other tests, including:

  • Magnetic resonance imaging (MRI). 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.

Management and Treatment

How is invasive ductal carcinoma treated?

There are several approaches that can be used when treating this type of breast cancer. Specific treatment depends on the size and location of your tumor, your healing capacity and your personal preferences. Invasive ductal carcinoma treatments include:

  • Breast cancer surgery. A surgeon removes the tumor and confirms whether or not the cancer has spread to the lymph nodes. Some people may only have the tumor removed (lumpectomy), while others may have some or all of their breast tissue removed (mastectomy).
  • Chemotherapy. For people with invasive ductal carcinoma, chemotherapy may be given before surgery to shrink the tumor or after surgery to reduce the chance of cancer returning. Chemotherapy may also be recommended as the main treatment for people with metastatic breast cancer.
  • Radiation therapy. In most breast cancer cases, radiation therapy is used after surgery to kill any remaining cancer cells. Occasionally, it may be used to shrink a tumor before surgery. Radiation therapy may also be recommended when a tumor can’t be surgically removed due to the size or location.
  • Targeted therapy. This treatment uses drugs to target certain characteristics of cancer cells. For example, if there’s a protein in your body that causes abnormal cells to multiply, your provider might give you drugs that target that specific protein.
  • Anti-hormone therapy. Sometimes called endocrine therapy, this treatment lowers the amount of estrogen in your body. This blocks estrogen from causing breast cancer cells to grow.
  • Immunotherapy. Used in combination with chemotherapy, this treatment uses the power of your immune system to fight cancer cells.

Are there side effects of invasive ductal carcinoma treatment?

Yes. As with any cancer treatment, side effects are possible. Your specific experience depends on how advanced your tumor is, where it’s located and what type of treatment you undergo.

People who have breast cancer surgery may experience infection, blood clots or complications from anesthesia. Those who undergo chemotherapy, radiation therapy, targeted therapy or immunotherapy may have:

For patients receiving anti-hormone therapy, the most common side effects are hot flashes, joint pain, weight changes, mood changes, vaginal dryness or discharge and decrease of sexual desire.

You may experience other symptoms, too. Your healthcare provider can tell you what to expect during invasive ductal carcinoma treatment.

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.

Prevention

How can I reduce my risk for invasive ductal carcinoma?

Like most cancers, knowing your family history can help you take preventative steps, such as early screenings and mammograms. Even though invasive ductal carcinoma can’t be prevented altogether, there are steps you can take to lower your risk:

  • Maintain a healthy body weight.
  • Don’t smoke.
  • Limit alcohol intake.
  • Exercise regularly.
  • Eat a healthy, well-balanced diet.
  • Undergo genetic testing for gene mutations if recommended based on family history.

Outlook / Prognosis

What can I expect if I have invasive ductal carcinoma?

If you’ve been diagnosed with invasive ductal carcinoma, your healthcare provider will discuss your treatment options with you in detail. For best results, you’ll want to begin treatment as soon as possible.

How curable is invasive ductal carcinoma?

Invasive ductal carcinoma is quite curable, especially when detected and treated early.

What is the survival rate for invasive ductal carcinoma?

The five-year survival rate for localized invasive ductal carcinoma is high — nearly 100% when treated early on. If the cancer has spread to other tissues in the region, the five-year survival rate is 86%. If the cancer has metastasized to distant areas of your body, the five-year survival rate is 28%.

Keep in mind that survival rates cannot tell you how long you will live. These numbers are based on people who have undergone breast cancer treatment in the past. For more information about your specific case, talk to your healthcare provider.

Living With

When should I see my healthcare provider regarding invasive ductal carcinoma?

If you notice any unusual changes in your breast tissue, schedule an appointment with your healthcare provider. If you’re currently undergoing treatment for invasive ductal carcinoma, call your healthcare provider if you develop any concerning symptoms, such as high fever, chills, confusion, chest pain, shortness of breath (dyspnea), bone pain or abdominal pain.

What questions should I ask my healthcare provider about invasive ductal carcinoma?

Fully understanding your situation can empower you and help you take control of your health. Here are some questions you might want to ask your healthcare provider:

  • What stage of invasive ductal carcinoma do I have?
  • How far has my cancer spread?
  • What are my treatment options?
  • How long will my treatment take?
  • Will I be able to work during my treatment?
  • What are my chances of survival?

Frequently Asked Questions

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.

Last reviewed by a Cleveland Clinic medical professional on 11/29/2021.

References

  • American Cancer Society. Invasive Breast Cancer (IDC/ILC). (https://www.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/invasive-breast-cancer.html) Accessed 11/29/2021.
  • American Cancer Society. Triple-negative Breast Cancer. (https://www.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/triple-negative.html) Accessed 11/29/2021.
  • Breastcancer.org. Breast Cancer Stages. (https://www.breastcancer.org/symptoms/diagnosis/staging) Accessed 11/29/2021.
  • Breastcancer.org. Invasive Ductal Carcinoma (IDC). (https://www.breastcancer.org/symptoms/types/idc) Accessed 11/29/2021.
  • Cancer.net. Breast Cancer: Stages. (https://www.cancer.net/cancer-types/breast-cancer/stages) Accessed 11/29/2021.
  • de Blok CJM, Wiepjes CM, Nota NM, et al. Breast cancer risk in transgender people receiving hormone treatment: nationwide cohort study in the Netherlands. (https://pubmed.ncbi.nlm.nih.gov/31088823/) BMJ. 2019 May 14;365:l1652. Accessed 11/29/2021.
  • National Breast Cancer Foundation, Inc. Invasive Ductal Carcinoma (IDC). (https://www.nationalbreastcancer.org/invasive-ductal-carcinoma) Accessed 11/29/2021.

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