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Infiltrating Ductal Carcinoma

Infiltrating ductal carcinoma (IDC) or also known as invasive ductal carcinoma is the most common form of breast cancer that begins in the milk ducts (tubes that carry milk from the glands to the nipples), grows through the duct wall and then spreads to the other nearby fibrous or fatty tissues of the breasts. Once cancer spreads to the surrounding breast tissue, it can very easily evade other organs and tissues of the body. Over time, this form of breast cancer can spread to lymph nodes and other areas. Infiltrating ductal carcinoma accounts for 80% of the women diagnosed with breast cancer. 

While infiltrating ductal carcinoma can affect women of all ages; however, it is more likely to affect women of older age, such as 55 or above. That said, infiltrating ductal carcinoma can also impact men. 

Causes of Infiltrating Ductal Carcinoma

The exact cause of infiltrating ductal carcinoma is not identified; however, a few factors such as genes mutations, hormonal, lifestyle and environment can increase the chances of a person being diagnosed with this form of breast cancer. That said, these below factors also increase the likelihood of a person being affected with infiltrating ductal carcinoma:

  • Being female – since women are more likely to have breast cancer than men.
  • Increasing age
  • Abnormal breast conditions
  • Past record of breast cancer
  • Family history of breast cancer
  • Inherited gene mutations
  • Exposure to radiation
  • Obesity
  • Alcohol
  • Early age period (before 12 years of age)
  • Older age menopause
  • Conceiving first child at an older age
  • Never being pregnant
  • Postmenopausal hormone therapy

Symptoms of Infiltrating Ductal Carcinoma

Like other breast cancers, infiltrating ductal carcinoma might not produce any symptoms during early stages unless detected via a mammogram, which might reveal a suspicious mass. However, a woman might discover a lump or abnormal mass upon self-examination of the breasts and get a diagnosis to confirm cancer. The most common symptom that can help with diagnosis is the formation of a lump, though not all breast lumps are cancerous, and hence, a medical diagnosis will be required to confirm the analysis. 

That said, some other symptoms that might help to diagnose infiltrating ductal carcinoma are:

  • An abnormal and sudden appearance of a lump
  • Sudden thickening in the breast tissue/skin
  • Pain in the breast
  • Redness, pitting and rashes on the skin of the breasts – like an orange
  • Swollen breasts; especially one breast
  • Sudden, new pain in one location of the breast
  • Discharge from nipple (apart from breast milk)
  • Blood discharge from the nipple
  • Peeling, scaling or flaking of the breast skin or tissue
  • Inverted nipple
  • Pain in the nipple
  • Dimpling around the nipple
  • Difference in the appearance of breasts and its skin
  • Change in breast shape and size
  • Tenderness in the breast
  • A lump or swelling under the arm

Just mere presence of these symptoms does not confirm infiltrating breast carcinoma because these symptoms can also occur because of other reasons such as cysts. Hence, a medical diagnosis is required to confirm the analysis and get targeted treatment.

Diagnosis of Infiltrating Ductal Carcinoma

It is hard to detect infiltrating ductal carcinoma generally unless examined via a mammogram – the X-Ray of the breasts. To check for cancer, the cells will be collected and assessed through a biopsy, where the doctor will confirm or deny breast cancer. Once, the biopsy confirms the presence of infiltrating ductal carcinoma – a few other tests will be conducted to assess the size, shape and aggressiveness of the tumour. These tests include:

  • CT scan
  • PET scan
  • MRI
  • Bone scan
  • Chest X-ray

Stages of Infiltrating Ductal Carcinoma

The diagnostic tests of infiltrating ductal carcinoma are also essential to assess the stage of cancer in terms of size and aggressiveness (the speed of spreading). The tests also determine how far cancer has spread and how much it has affected other body organs and tissues. 

Treatment for Infiltrating Ductal Carcinoma

 Treatment for infiltrating ductal carcinoma is dependent on the stage of cancer, i.e. the current size and rate of growth of cancer. Some of the common treatment options include:

Surgery: This is the most commonly opted method to treat infiltrating ductal carcinoma. Different types of surgeries include:

  • Lumpectomy in which the tumour and the surrounding tissue is removed, leaving the rest of the breast intact.
    • Mastectomy in which the entire breast or breasts are removed
    • Sentinel node biopsy in which the lymph nodes that receive the drainage from the tumour are removed. These lymph nodes are assessed for cancer.
    • Axillary lymph node dissection: If the lymph nodes removed during a sentinel node biopsy are detected with cancer cells, additional lymph nodes may be removed.
    • Contralateral prophylactic mastectomy: This is an optional surgery where the patient can opt to remove both breasts even when the cancer is present in only one breast; this helps to reduce the risk of developing infiltrating ductal carcinoma again.

Radiation: In radiation therapy, powerful beams are used to target and destroy cancer cells. In the form of radiation therapy, cancer cells are destroyed from inside the body by placing radioactive seeds or pellets inside the patient’s body, near the site of the tumour. These seeds remain in the body for a short period of time and effectively destroy cancer cells. This type of treatment is also known as brachytherapy. 

Chemotherapy: This form of treatment is done in combination with some other treatment method to enhance its impact in destroying cancer cells. Chemotherapy is widely used in combination with surgery, where the patient might be asked to undergo chemotherapy to shrink the size of the tumour so that the surgery is less invasive.

Hormone Therapy: This type of treatment is used to correct hormones that promote tumour. For cases, where infiltrating ductal carcinoma cancer is sensitive to specific hormones – such as estrogen and progesterone – the production of the particular hormones in the body is slowed or restricted through prescribed medicines. This helps in taming the invasiveness of breast cancer.

Medications: The doctor will suggest targeted medicines to control the growth of infiltrating ductal carcinoma and target abnormalities and mutations in the cancer cells. 

Though highly common, infiltrating ductal carcinoma can be treated provided it is diagnosed early, and targeted course of treatment is initiated timely.

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