Ductal Carcinoma is a common form of breast cancer that starts in the milk ducts that lie beneath the skin and lead to the nipple.
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| Invesive ductal Carcinoma |
What are the types of ductal carcinoma?
Basically two types of ductal carcinoma exists:
- Ductal carcinoma in situ (DCIS), also called intraductal carcinoma
- Invasive ductal carcinoma (IDC)
They both differ in symptoms, diagnosis, and treatment.
Ductal carcinoma insitu accounts for 1 in every 5 diagnoses of breast cancer.
It's a non-invasive growth of cells within the breast ducts uncontrollably. Its non-invasive because it hasn't grown into the breast tissue outside of the ducts.
It is the earliest stage of breast cancer and it's curable (stage 0).
It can lead to an invasive cancer about 30% of sufferers within 10 years of diagnosis. So women with the disease require medical treatment. The invasive cancer usually develops in the same breast and area where the Ductal carcinoma insitu occured.
What are ductal carcinoma in situ symptoms?
Usually there is no visible or palpable lump. Common symptoms include breast pain and a bloody discharge from the nipple.
How is Ductal Carcinoma Insitu Diagnosed
About 80% of cases are picked up by mammograms. Usually doctors describe it as a shadowy area on mamogram. A suspicious mamogram is not final, your doctor will require a biopsy to identify the cancer cells. A little needle will be inserted in your breast and small tissue taken to be analyzed by the pathologists.
Your doctor may offer more tests if your biopsy turns out positive for ductal carcinoma insitu. This test includes an MRI and Ultrasonography. They will help tell the extent of the disease.
How is ductal carcinoma in situ treated?
Treatment depends on how your disease presents. So your doctor will make an informed choice based on:
- Tumor location
- Tumor size
- Presense of aggressive cancer cells
- If a member of your family had breast cancer in the past
- If you have gene mutation which increases your cancer risks.
The following are options of treatment:
Most women will benefit from breast conserving surgery and not a masectomy (breast removal).
Commonly a lumpectomy which involves removing the cancer and a small area of normal tissue, followed by radiation therapy is done.
This significantly reduces the likelihood that the cancer will return (recurrence).
Women with very low risk may require just a lumpectomy done.
Masectomy maybe necesssary in the following situations:
- Strong family history of breast cancer
- A gene mutation that increases the risk of breast cancer
- Huge Ductal Carcinoma Insitu
- Lesions located in multiple areas throughout your breast
- Inability to tolerate radiation therapy
Hormone therapy maybe considered. This reduces risk of invasive cancer in both breasts (normal and abnormal).
What is an Invasive Ductal Carcinoma
Accounts for about 80% of all invasive breast cancers in women and 90% in men.
It also begins in the milk ducts and grows through the duct walls and into the surrounding breast tissue. And it can spread to other parts of your body(metastases).
How is invasive ductal carcinoma diagnosed?
Your doctor may recognise a hard, immovable lump with irregular edges to form in your breast. It can sometimes be felt during a breast examination. In some cases, the cancer causes the nipple to become inverted.
On mammogram it may show areas of calcification.
If your physical exam and mammogram suggests you may have Invasive ductal carcinoma you’ll need a biopsy to collect cells for analysis.
Additional tests to look for cancer cells in other areas of your body since invasive ductal carcinoma. These tests may include:
- CT scan. This machine takes pictures of your body
- PET scan this test together with CT Scan can help find cancer in lymph nodes and other areas.
- MRI. also takes pictures to identify cancer cells
- Bone scan. We help identify if it has spread to your bones.
- Chest X-ray: helps identify if it has spread to your chest.
- Axillary lymph node dissection: determine if it has spread to your lymph nodes.
The results from these tests will tell the stage of your cancer, and knowing the stage will help guide your treatment.
Causes of Invasive Ductal Carcinoma
From results of extensive studies, scientists have identified certain hormonal, environmental and lifestyle factors that are believed to influence a person’s breast cancer risk, such as smoking, poor nutrition and prior radiation therapy administered to the chest area.
In rare cases, the causes of invasive ductal carcinoma have been traced to inherited attributes, such as mutations of the:
- Breast cancer gene 1 (BRCA1), a tumor suppressor gene
- Breast cancer gene 2 (BRCA2), a tumor suppressor gene
- ErbB2 gene, which produces the HER2 protein that promotes cellular proliferation.
How is invasive ductal carcinoma treated?
Most women with Invasive Ductal Carcinoma will require surgery to remove the cancer. It will be either lumpectomy or mastectomy depending on the size of your tumor and how much it has spread throughout your breast and surrounding lymph nodes.
Most doctors will recommend other treatments added to surgery including chemotherapy, hormone therapy, radiation therapy, or a combination of these treatments.
They all have different benefits.
