Invasive ductal carcinoma
What is invasive ductal carcinoma of the breast?
Invasive ductal carcinoma (IDC) of the breast is one of the most common breast diseases in women and men, and is more than 80% and 90%, respectively, in relation to other malignant breast tumors.
This cancer type may also be called:
- Invasive ductal carcinoma of the breast;
- Invasive non-specific breast cancer;
- Invasive cancer or carcinoma of the breast ducts.
Occurrence of invasive ductal carcinoma
The mammary gland consists of lobules and the milk ducts itself, which are surrounded by glandular, connective and adipose tissue.
Invasive ductal carcinoma occurs when normal cells in the ducts of the mammary gland turn into malignant cells as a result of a gene failure, and they start to mis-divide and spread throughout the organ. Invasive ductal carcinoma means that cancer has already invade to nearby breast tissue, and has the risk of spreading into the lymphatic system and other parts of the human body.
A biopsy from invasive ductal carcinoma is examined by pathologist in the laboratory, according to a special scale from 1 to 3, depending on the aggressiveness and growth of cancer cells:
- 1 – sluggish form of cancer, which is characterized by slow growth;
- 2 – moderate growth of cancer cells;
- 3 – fast-growing form of cancer.
Symptoms of invasive ductal carcinoma
Symptoms may include a variety of manifestations:
- • A lump in the breast.
- • A lump under the arm.
- • Changes in the appearance of the breast skin as grooves or folds
- • Changes in the breast shape.
- • Changes in nipple shape.
- • Unusual nipple discharge.
- • Prolonged discomfort or pain.
It is important to pay attention to the symptoms, as well as to conduct permanent self-examination using palpation. Often the malignant process can be asymptomatic and can only be detected at the initial stage during a medical examination.
Prof. Tamar Safra – Israel’s leading specialist in the treatment of invasive ductal carcinoma:
Head of the Department of Oncogynecology and Breast Cancer. Medical Center Suraski (Ichilov). Clinic Lys – Gynecology and Maternity Hospital. Department of Oncology.
Diagnosis of invasive ductal carcinoma in Israel
Diagnosis of invasive ductal carcinoma is performed by a doctor based on the instrumental examination and imaging anylysis. It may include:
- • Mammography.
- • Ultrasound examination of the breast and regional zones.
- • Fine-needle method or biopsy of the breast or lymph glands, with examination by a pathologist of tumor tissue.
- • Magnetic resonance imaging with a contrast.
Treatment of invasive ductal carcinoma in Israel
As a rule, the main method for this type of malignant disease is a surgical treatment to remove a tumor. There are such operations as:
- • Lumpectomy – organ-sparing surgery. In this operation, the oncology surgeon takes into account the following factors: primary or locally advanced cancer, the tumor infiltration into adjacent breast tissue, as well as the foci number of the malignant process in the breast.
- • Mastectomy – a radical surgery to remove a breast in case lumpectomy is impossible according to indications, or the patient has chosen this operation. Sometimes radiation therapy is not required after the removal of the breast. Also, the doctor will offer options for breast restoration using implants.
The operation to remove the lymph nodes.
Cancer cells can spread through the lymphatic system, so if you suspect – part of the lymph nodes is removed and sent for a biopsy diagnostics, or all nodes are removed if the diagnosis is confirmed.
Additional – Adjuvant (neoadjuvant) therapy
The decision and recommendations for additional or adjuvant treatment are taken by attending oncologist based on the operation and research results. The goal of adjuvant therapy is to reduce the possibility of the disease recurrence in the breast or in the form of metastases spreading to other body parts, and to consolidate the result of remission, or cure for cancer. At the same time, the expected benefits from adjuvant therapy, which may include targeted therapy, possible side effects, are evaluated, and patient preferences are taken into account. Usually includes chemotherapy and anti-HER2 therapy as indicated.
Learn more about adjuvant therapy in Israel
When medication is prescribed before surgery, this is called neoadjuvant therapy. It is recommended only by a doctor at the first stage as clinical studies.
Chemotherapy is a treatment using medical cytotoxic drugs which destroy cancer cells.
It is to be assigned with receptors presence in atypical cells of invasive ductal carcinoma that respond to the hormones estrogen and progesterone (ER +). The entire biopsy is necessarily tested for the presence of estrogen receptors and progesterone in the cancer.
If the test is positive, in this case, the attending physician will propose a suitable hormone therapy.
Radiation or radiotherapy – X-ray irradiation for the destruction of malignant tumors. After lumpectomy, radiation therapy is usually always given to reduce the risk of recurrent breast cancer. Also, after radical surgery – mastectomy with a high risk of recurrence or when a disease is detected in the lymph nodes of the armpit.
This group of drugs includes components that block the growth and spread of malignant cells, affecting the cell physiology. The most widely used drug in targeted therapy is Herceptin, which acts on a tumor with a high level of HER2 protein.
Immunity check-point inhibitors
This is a type of drug treatment that is an evolution after targeted therapy – and has anti-cancer effect in all types of malignant tumors. ICPI restore the stumbling immunity mechanism to fight the disease. The most popular anti-cancer drug targeting an immune checkpoint are anti-CTLA4, anti-PD-1, and PD-L1 antibodies.
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