Invasive Ductal Carcinoma (IDC) | Johns Hopkins Medicine

Invasive ductal carcinoma, also known as infiltrating ductal carcinoma or IDC, is the most common form of breast cancer, accounting for 80% of all breast ... SkipNavigation COVID-19Updates Masksarerequiredinsideallofourcarefacilities.Wearevaccinatingalleligiblepatients.Learnmore: Vaccines,Boosters&AdditionalDoses|Testing|PatientCare|VisitorGuidelines|Coronavirus|EmailAlerts FindmoreCOVID-19testinglocationsonMaryland.gov. HealthHome ConditionsandDiseases BreastCancer InvasiveDuctalCarcinoma(IDC) ShareonFacebook ShareonTwitter ShareonLinkedin ShareonPinterest ShareviaEmail PrintthisPage Breast BreastCancer Biopsies FeaturedExperts: PamelaWright,M.D. Invasiveductalcarcinoma,alsoknownasinfiltratingductalcarcinomaorIDC,isthemostcommonformofbreastcancer,accountingfor80%ofallbreastcancerdiagnoses. PamelaWright,M.D.,medicaldirectoroftheBreastCenteratJohnsHopkins’SuburbanHospital,tellsyouwhatyoushouldknowaboutIDC,itsdiagnosisandadvancementsintreatment. WhatYouNeedtoKnow Theriskofgettinginvasiveductalbreastcancerincreaseswithage:AccordingtotheAmericanCancerSociety,abouttwo-thirdsofwomendiagnosedwithIDCareage55orolder. IDCcanaffectmen. Withoutprompttreatment,invasiveductalcarcinomacanspreadtolymphnodesorbloodvesselsandmetastasize(spread)throughoutthebody. Identifyingcharacteristicsofthetumor,suchaswhetherornotthecellsaresensitivetocertainhormones,canhelpyourdoctorchoosethebesttreatment. Whatisinvasiveductalcarcinoma? Breastductsarethepassagewayswheremilkfromthemilkglands(lobules)flowstothenipple. Invasiveductalcarcinomaiscancer(carcinoma)thathappenswhenabnormalcellsgrowingintheliningofthemilkductschangeandinvadebreasttissuebeyondthewallsoftheduct. Oncethathappens,thecancercellscanspread.Theycanbreakintothelymphnodesorbloodstream,wheretheycantraveltootherorgansandareasinthebody,resultinginmetastaticbreastcancer. Whatarethesymptomsofinvasiveductalcarcinoma? “Likeotherbreastcancers,IDCmaypresentasalumpthatyouoryourdoctorcanfeelonabreastexam.Butinmanycases,atfirst,theremaybenosymptoms,”Wrightsays. “Thatiswhyitisimportanttohavescreeningmammogramstodetectbreastcancerssuchasinvasiveductalcarcinoma.Amammogrammaydetectalumpthatistoosmallforyoutofeel,orsuspiciouscalcificationsinthebreast,eitherofwhichwillleadtofurthertesting.” AccordingtoWright,thefollowingarepossiblesignsofinvasiveductalcarcinomaandotherbreastcancers.Ifyounoticeanyofthese,youshouldcontactyourdoctorrightawayforfurtherevaluation: Lumpinthebreast Thickeningorrednessoftheskinofthebreast Swellingorchangeintheshapeofthebreast Localizedpersistentbreastpain Dimplingorretractionoftheskinofthebreastorthenipple Nippledischarge,otherthanbreastmilk Scalyorflakyskinonthenippleoranulceration(sore)ontheskinofthebreastornipple.ThesecanbesignsofPaget’sdisease,adifferentkindofbreastcancerthatcanoccuralongwithIDC. Lumpsintheunderarmarea Changesintheappearanceofthenippleorbreastthataredifferentfromyournormalmonthlychanges Howisinvasiveductalcarcinomadiagnosed? SeveraltestscanhelpyourdoctoridentifyanddiagnoseIDC,including: Physicalexam.Manualexaminationofyourbreastsbyyourdoctorcandetectlumpsandotherchanges.Ifyourdoctorfeelsalumporthickening,heorshemayrecommendfurtherteststoruleoutIDC. Digitalmammography isanimprovedmethodforbreastimagingthatisperformedmuchlikearegularmammogram.However,itisbetterthanconventionalmammographyindetectingcancerinyoungerpatientsandinthosewithdensebreasttissue.Electronicimagescanbeenhancedwithcomputer-aideddetectionsystemstospotmasses,calcificationsandabnormalitiesassociatedwithcancer. Breastultrasoundusessoundwavestoexaminethebreasttissueandgaugebloodflow.Itissafeforexaminingpregnantpatients,anddoesnotuseradiation. Breastmagneticresonanceimaging(MRI)usesalargemagnet,radiowavesandacomputerthatcandetectsmallbreastlesions,andmaybeespeciallyusefulinexaminingpatientswithahighriskofbreastcancer,suchasthosewithBRCA1,BRCA2orothergenemutationsassociatedwithcancer. ScheduleYourMammogram Bethesda Columbia GreenSpringStation WhiteMarsh Seeallimaginglocations Biopsy.Abreastbiopsy involvestakingasampleofbreasttissuefromasuspiciousareaandsendingittoalaboratoryformicroscopicexaminationbyapathologist,adoctorwhospecializesinidentifyingsignsofdisease.Abiopsycanconfirmorruleoutthepresenceofcancerand,ifcancerispresent,revealitscharacteristics. Stagingworkup.Whencancerisdetected,thenextstepisstaging.“Stagingdetermineshowfarthecancercellshavespread,”Wrightsays.“Stagingisbasedonthesizeofthetumorandwhetherornotithasspreadtothelymphnodesorenteredthebloodstreamandspreadanywhereelseinbody.” InvasiveDuctalCarcinomaTreatment “Treatmentisbasedonthesizeandlocationofthecancercells,thefeaturesorcharacteristicsofthosecells,andthestaging,”Wrightsays.Dependingonthesefactors,yourdoctorwillrecommendaplanthatincludesoneormoreofthefollowingtreatments. SurgeryforInvasiveDuctalCarcinoma Breastcancertreatmenthasevolvedtoofferpatientsmoreoptions.Inadditiontoremovingbreastcancer,newaestheticsurgicalapproachescanenhancewell-beingandlessentheemotionalimpactoflosingallorpartofabreasttocancer.Comprehensivebreastcenterswithcoordinatedteamsofoncologicandplasticsurgerypractitionerscanofferawiderarrayofoptions. SurgeryforIDCmayincludeoneoftheseprocedures: Lumpectomyisremovalofpartofthebreast.Itisalsoknownasbreast-conservingsurgery.Lumpectomymaybefollowedbyradiationtreatmentstotreatanyremainingcancercells. Mastectomyisremovalofthebreast.Mastectomyisatreatmentforpatientswithmultiple,veryaggressive,orlargeinvasiveductaltumors.Itcanbefollowedbybreastreconstruction. NonsurgicalInvasiveDuctalCarcinomaTreatment Radiation.Radiationtherapymightbepartofyourtreatmentplanifyouareundergoingalumpectomy.StudiesshowthatlumpectomyfollowedbyradiationcanbeaseffectiveintreatingIDCasmastectomy.“Wedon’tusuallytreatpatientswithradiationafteramastectomyunlessthere’ssomecancerinthelymphnodes,”Wrightsays. Chemotherapy.Decidingonwhethertotreatinvasiveductalbreastcancerwithchemotherapy,or“chemo,”dependsonfeaturesofthetumorcellsthemselves—theirgenesandproteins.Themorethedoctorcanlearnaboutthecharacteristicsofthecancercells,theeasieritistodeterminewhattypeofchemotherapy(ifany)islikelytobeeffective. Hormonetherapy.Breastcancerswithpositivehormonereceptorscanbetreatedwithestrogenorprogesterone.Thesemedicationscomeinpillform,andmaybeprescribedforseveralyears. Biologic(targeted)therapy.Thisapproachusesantibodiesorsmallmoleculedrugstoactivateyourbody’simmunesystemtofighttheinvasiveductalcancercells. DecidingonInvasiveDuctalCarcinomaTreatment Treatmentforductalbreastcancerisnotonesizefitsall.Yourdoctorwillconsiderseveralfactorsinputtingtogetheranindividualizedtreatmentplanforyou,includinghowadvancedthecancerisandthecharacteristicsofthetumorortumors. Wrightsaysthebiopsycanrevealhowthetumorislikelytorespondtovarioustherapies.Forexample,analysismayrevealthepresenceofcertainproteinsonthecells’surface(suchashumanepidermalgrowthfactor2,orHER2)orhormonereceptorsforestrogenorprogesterone.Thesecharacteristicscanindicatetumorsthatcanbetreatedwithhormonetherapy. CheckingforDuctalBreastCancerinLymphNodes “Thegoalofinvasiveductalcarcinomatreatmentistogetthecanceroutofthebreast.Butwealsomayneedtoremovelymphnodesifthecancerhasspreadthere,”Wrightexplains. Yourlymphnodesarepartofyourimmunesystem.Lymphfluidfromthebreastdrainsintotheaxillary(underarm)lymphnodes.Thenumberandlocationofaxillarylymphnodesmaybedifferentfrompersontoperson. Asentinellymphnodebiopsyisatestthatcanhelpyourdoctordetermineifremovinglymphnodesmaybepartofyourcancersurgery. Thesentinellymphnodeiswherecancerfrominvasiveductalcarcinomaislikelytoshowupfirst.Yourdoctorcanidentifythesentinellymphnodebyinjectingdyeintothebreastandseeingwhichnodetakesupthedyefirst:Thisisthesentinel.Asampleoftissuefromthisnode(biopsy)canrevealifcancerhasspreadthere. “Ifthere’snocancerinthesentinelnode,theothernodesareOKanddon’tneedtoberemoved,”saysWright.“Ifthere’sasmallamountofcancerpresent,we’llleavenodesinplaceandtreattheareawithradiationorusechemotherapy. “Ifweseealotofcancerinthelymphnodesoriffourormorelymphnodesareaffected,weperformanaxillarylymphnodedissection:surgerytoremovethenodes.” Didyouknow?Mencangetbreastcancer,too About1in100breastcancersoccursinmen.Thoughmendonothaveenoughlobulartissuetoproducemilk,theydohavemilkducts,andcancercanarisethere. Learnmoreaboutbreastcancerinmen Raretypesofinvasiveductalcarcinoma Medullaryductalcarcinomaaccountsforonly3%–5%ofbreastcancers.Itmayappearonamammogram,anditdoesnotalwaysfeellikealump;rather,itcanfeellikeanabnormallyspongyareainthebreasttissue. Mucinousductalcarcinomaisalsocalledcolloidbreastcancer.Itoccurswhencancercellswithinthemilkductofthebreastproducemucous,whichalsocontainsbreastcancercells.Thecellsandmucouscombinetoformatumor.Puremucinousductalcarcinomatendstogrowslowly,andhasabetterprognosisthansomeothertypesofIDCs. Papillarycarcinomaformsfinger-likeprojections(papules)thatcanbeseenunderamicroscope.Manypapillarytumorsarebenign,buteventhosethatbecomecancerousareusuallyverytreatablewithagoodprognosis.Papillarycarcinomamostcommonlyoccursinpeopleolderthan60. TubularductalcarcinomaisararediagnosisofIDC,comprisingonly2%ofbreastcancerdiagnoses.Thenamecomesfromhowthecancerlooksunderthemicroscope—likehundredsoftinytubes.Tubularbreastcancerhasanexcellentprognosis. Whatistheprognosisforinvasiveductalcarcinoma? Yourdoctorwilldiscusswhatyoucanexpectbasedonthecharacteristicsoftheinvasiveductalcarcinomaandtheeffectivenessofyourtreatment. SpecialtycenterssuchasJohnsHopkinsMedicine’sBreastHealthServicescanofferintegratedteamsofbreastcancerspecialistswhohaveskillandexperienceinsurgery,breastreconstruction,chemotherapy,biologictargetedtherapy,radiationtherapyandotherhormonaltherapies. “Medicalscienceismakinggreatstridesforwardintreatingbreastcancer,allowingoursurgeriestobelessinvasiveandimprovingsurgicaloutcomesandoverallqualityoflife,”Wrightsays. BreastHealthServices JohnsHopkinsbreasthealthservicesincludepreventiveandnoncanceroussurgicaltreatment,riskassessment,diagnosticscreeningsandtreatmentforbreastcancer. Findbreasthealthcare FindaDoctor SpecializingIn: BreastCancer Mammography AtAnotherJohnsHopkinsMemberHospital: HowardCountyGeneralHospital SibleyMemorialHospital SuburbanHospital FindaTreatmentCenter BreastCancerProgram FindAdditionalTreatmentCentersat: HowardCountyGeneralHospital SibleyMemorialHospital SuburbanHospital Related MastectomyVersusLumpectomy:3QuestionstoAskYourDoctor InvasiveLobularCarcinoma HereditaryBreastCancer MetastaticBreastCancer RequestanAppointment FindaDoctor 410-955-5000 Maryland 855-695-4872 OutsideofMaryland +1-410-502-7683 International FindaDoctor SeeMore Related Breast MastectomyVersusLumpectomy:3QuestionstoAskYourDoctor Breastcancer InvasiveLobularCarcinoma Breastcancer HereditaryBreastCancer RelatedTopics Breast BreastCancer Biopsies