In today’s post, we talk about Invasive Ductal Carcinoma (IDC), one of the most commonly occurring breast cancers in women. IDC is treatable with early diagnosis. Let’s know more about how to check for symptoms and treatment methods.

What is Invasive Ductal Carcinoma?

Any cancer that occurs on the skin or tissue that covers internal organs is called a Carcinoma. Invasive Ductal Carcinoma also called Infiltrating Ductal Carcinoma, is cancer that originates in the ducts which carry breast milk from the lobules to the nipple. Its invasive nature suggests that it can spread from the ducts to the surrounding healthy breast tissues. If this cancer goes unchecked, it can affect lymph nodes and other organs of the body.

IDC accounts for 80% of all cancer cases reported every year. According to the American Cancer Society, almost 180,000 new invasive ductal carcinoma cases are reported in the United States alone. Two-thirds of the affected women are above the age of 55. IDC can affect men too.

Signs and symptoms

In the beginning, IDC may not exhibit any symptoms. It usually shows up in the form of a lump upon physical examination and can be confirmed using a mammogram. Generally, any difference from the normal state of the breast is a cause of concern and could be a sign of breast cancer like IDC. The common symptoms to watch out for are-

  • swelling
  • irritation
  • dimpling
  • pain
  • inverted nipple or nipple pain
  • thickened breast skin
  • nipple discharge
  • lump in the underarm area

If you notice any strange changes in your breasts, check with a doctor immediately.

Diagnosis

IDC can be diagnosed using a combination of tests like imaging tests and physical examination.

  • Physical examination: The doctor may find a small lump or a difference in the lymph nodes in the underarm area or collarbone.
  • Mammography: This is one of the best ways to confirm invasive ductal carcinoma. In IDC, finger-like projections or spiculated margins are what indicate invasiveness. Mammograms are very useful in diagnosing early-stage breast cancers. Depending upon the results, more mammograms will be performed for a thorough investigation.
  • Ultrasound: Ultrasound imaging is another commonly used diagnostic method for IDC. It is usually used to evaluate the tumors discovered in mammograms.
  • Breast MRI: Magnetic Resonance Imaging is another test required to gather more information about the breast. The scans give detailed images of the breast and help in diagnosing and locating the tumors precisely.
  • Biopsy: Depending on the physical examination and the imaging test, a biopsy may be required for further assessment. A biopsy involves taking a sample of the tissue from the breast. It can be of varying degrees of invasiveness.
  • Stereotactic needle biopsy: When the doctors cannot feel the lump, they use ultrasound or mammogram as a guide while performing the biopsy. This method is also called an ultrasound-guided biopsy.

The less invasive methods include fine needle aspirations, which leaves no scars, and core needle biopsy, which leaves a tiny scar for a few weeks.

The more invasive kind of biopsies includes incisional biopsy and excisional biopsy. These biopsies are more like surgeries than needle biopsies since bits or whole of the affected tissue are removed from the breast.

Once the diagnoses confirm invasive ductal carcinoma, surgery is required to remove the cancerous growth with clear margins. Clear margins refer to a border of healthy tissue around cancer, which is also removed in the process. Partial removal of breast tissue called lumpectomy or complete removal of the breast, called mastectomy, is performed.

Tests for Staging IDC

Several tests are carried out to determine how far the IDC has spread from the original location. This process is called staging. The size of the tumor and the extent to which cancer has spread can be determined from the results. Thorough investigations are conducted via Bone scan, CT scan, ultrasound, MRI, PET scan, CT scan, etc., to determine how far cancer has spread- whether it has affected the lymph nodes or any other parts of the body. It is then described on a scale from stage I to stage IV.

Further, the following information is gathered to determine which treatment would be the most beneficial.

  • Grade Of The Tumor- how the cells behave compared to healthy breast cells
  • Surgical Margins- the healthy tissues that are just outside the affected area
  • Hormone Receptor Assay- whether cancer cells have estrogen and progesterone receptors
  • HER2-receptor Status- information on the HER2 receptors which can cause cells to grow faster

Treatment

The treatment for IDC depends upon the stage, grade, and other factors. The standard treatments for IDC are:

  • Surgery: Surgery is used as a diagnosing tool as well as a treatment method. Based on the doctor’s findings, lumpectomy (removing the affected mass of tissue or the “lump” ), mastectomy (removing portions or the whole breast tissue), and lymph node surgery.
  • Chemotherapy: Medicines may be used in combination with surgery depending upon the stage of cancer. The medicines attack and destroy all cancerous cells by traveling through the bloodstream. At times, they may damage the healthy cells and cause side effects. Chemotherapy is usually done through an IV infusion, but pills are also used at times.
  • Radiation therapy: High-energy radiation is used to destroy any residual cancer cells left behind after surgery. This treatment is recommended to reduce the risk of recurrence. Radiation therapy often accompanies lumpectomy and a partial mastectomy.
  • Hormonal therapy: Hormonal therapy, which is also called anti-estrogen or endocrine therapy, is used before or after surgery, depending upon the need. This form of therapy blocks estrogen and inhibits the growth of breast cancer cells. It is a systemic treatment as it affects the whole body.
  • Targeted therapy: This form of treatment includes using medicines that target specific characteristics of cancer cells, such as growth-promoting proteins. Since they affect the whole body, they are also systemic treatments.

Follow-Up Care

Post-treatment follow-ups must be done as per the advice of your doctor. You may be advised to take a physical exam every 4 to 6 months in the first five years and annually afterward. You may also be advised to take mammograms at periodic intervals to assess the breast tissues. Regular monitoring of bone density may be done as well.

Hope

IDC is a complex condition that requires urgent medical attention. With the right kind of awareness and prompt medical attention, the chances of survival are very high, giving us a second shot at life. Always be aware of the changes in your body. If you detect any strange pains or lumps, visit a doctor immediately.