What is Meant by Invasive Ductal Carcinoma?
Infiltrating or Invasive Ductal Carcinoma, which is also known by the name of Invasive Breast Cancer, is perhaps the most common variant of breast cancer in the United States(1). Invasive Ductal Carcinoma is a cancer that develops in the milk ducts of the breast and then rapidly spreads to involve the surrounding structures(2).
Invasive Ductal Carcinoma is so progressive that it can infiltrate even the lymph nodes and the circulatory system, which leads to the cancer spreading to various parts of the body. Even though Invasive or Infiltrating Ductal Carcinoma may be rapidly progressive, but it is still a treatable condition at least when identified in its initial stages.
There are various stages of Invasive Ductal Carcinoma. While stage 0 represents cancer that is localized; stage 1 to 4 are stages that indicates that the cancer is believed to have spread beyond its original area of development.
What Is The Cause Of Invasive Ductal Carcinoma?
The primary cause for a condition like Invasive or Infiltrating Ductal Carcinoma is still not completely clear, but researchers are of the opinion that when the cells present in the milk ducts tend to grow rapidly and uncontrollably, this results in Invasive Ductal Carcinoma(3, 4). These cells tend to survive longer than their actual span, which results in accumulation of excess cells taking the shape of a tumor of Invasive Ductal Carcinoma.
As the cells continue to grow rapidly, this mass or tumor then spreads to the adjoining structures resulting in malignancy. Why do the cells start growing rapidly is something, which is still a mystery(4).
However, researchers have been able to identify certain environmental, lifestyle and hormonal factors that makes an individual vulnerable to Invasive or Infiltrating Ductal Carcinoma. These include nicotine abuse, nutritional deficiencies, radiation to treat other forms of cancer around the region of the chest, which can increase the person’s risk for Invasive Ductal Carcinoma(4).
Certain genetic factors have also been identified as a potential cause for Invasive or Infiltrating Ductal Carcinoma like BRCA-1, BRCA-2, and erb-B2 gene, which have shown to increase the risk of Infiltrating Ductal Carcinoma(4).
What Are The Symptoms Of Invasive Ductal Carcinoma?
Nipple retraction is the first and foremost symptoms that can be observed in an individual with Invasive or Infiltrating Ductal Carcinoma(5). A self-breast exam can clearly show retraction of the nipple and alveolar complex. There may also be pain felt in the breast at times but this is not always the case. Other than this, there are no observable symptoms for Invasive or Infiltrating Ductal Carcinoma.
How is Invasive Ductal Carcinoma Diagnosed?
Invasive Ductal Carcinoma or Infiltrating Ductal Carcinoma can be diagnosed early by doing a self-breast examination(4). If there is retraction of nipples or a visible lump or bump observed, then prompt clinical evaluation is recommended.
Here, it should be noted every breast lump observed may not be Invasive Ductal Carcinoma or Infiltrating Ductal Carcinoma, but nevertheless it needs to be evaluated by a physician to identify or diagnose Invasive Ductal Carcinoma, if present in earlier stages can be treated early to improve the overall prognosis of the patient.
Some of the tests done to confirm the diagnosis of Infiltrating Ductal Carcinoma are: Mammogram, which is a detailed radiographic study of the breasts, which will identify an Infiltrating Ductal Carcinoma(4). An advanced ultrasound of the breasts is also a useful tool to confirm the diagnosis of Invasive Ductal Carcinoma.
Additionally, MRI of the breasts can be done, especially in young females as they have dense tissues and the MRI can clearly show the area of the breast, which has an overgrowth of cells indicating Invasive Ductal Carcinoma(4). In some cases, the above mentioned studies are not confirmative. In such instances, a biopsy of the lump in the breast will confirm the diagnosis of Infiltrating Ductal Carcinoma(6).
How is Invasive Ductal Carcinoma Treated?
The main aim of treatment of Invasive Ductal Carcinoma is to eliminate the cancer cells and prevent any chances of recurrence of this disease. For this, a lumpectomy, which is surgical removal of the tumor, is done. Along with the mass, the surrounding tissue which has been infiltrated by the tumor is also removed (8).
In cases, if the lump in Invasive Ductal Carcinoma is too large or the cancer has spread to encompass the whole breast, then mastectomy or surgical removal of all breast tissues is done (8). This is followed by chemotherapy to kill any remaining cancer cells. At times, radiation of the affected area is also done to get rid of any cancer cells.
Other treatments for Infiltrating or Invasive Ductal Carcinoma include: hormonal therapy if the cancer is believed to be caused by hormonal factors(9, 10). To check whether the cancer has spread to other parts of the body a PET scan will be done. In this study, radioactive material is injected into the veins and a thorough monitoring is done through imaging.
The areas affected by cancer will light up on the screen confirming metastasis. If the cancer has metastasized then further treatment in the form of radiation and chemotherapy will be done to eliminate all the cancer cells.
After Treatment for Invasive Ductal Carcinoma
Once the treatment for Invasive Ductal Carcinoma is over, it is mandatory for patients to follow up with their physicians closely with serial radiographic studies to ensure that there is no recurrence of the cancer. The monitoring is normally done for close to 3-4 years without any trace of recurrence before a patient can be deemed as cancer free. If the Invasive Ductal Carcinoma is supposed to be hormone sensitive, then the patient may need to be on hormone therapy for close to 10 years
What is the Long Term Outlook or Prognosis for Invasive Ductal Carcinoma?
The prognosis for Invasive Ductal Carcinoma depends on the cancer stage and when it was diagnosed. If the Invasive Ductal Carcinoma is diagnosed in its early stages, then the prognosis is quite good. However, the prognosis of Invasive Ductal Carcinoma becomes guarded to poor in cases where the cancer has spread to other parts of the body, especially the bones or lungs.