Invasive Ductal Carcinoma Stages
Invasive ductal carcinoma stages provide physicians with a uniform way to describe how far a patients cancer may have spread beyond its original location in a milk duct. This information can be helpful when evaluating treatment options, but it is not a prognostic indicator in and of itself. Many factors can influence a patients outcome, so the best source of information for understanding a breast cancer prognosis is always a physician who is familiar with the patients case.
In general, breast cancer stages are established based on three key variables: the size of a tumor, the extent of lymph node involvement and whether the cancer has spread to other areas of the body. This information may be obtained through a combination of clinical examinations, imaging studies, blood tests, lymph node removal and tissue samples . If, based on the initial test results, a physician believes that the cancer may have spread to other parts of the body, further testing may be ordered, such as a bone scan, positron emission tomography scan or liver function test.
Invasive ductal carcinoma is usually described through a numeric scale ranging from 1 to 4 . Specifically, the invasive ductal carcinoma stages are:
If youd like to learn more about invasive ductal carcinoma stages and treatment options, call or complete a new patient registration form online.
How Is Invasive Ductal Carcinoma Of Breast Treated
Treatment options available for individuals with Invasive Ductal Carcinoma of Breast are dependent upon the following:
- Type of cancer
- The staging of the cancer
- Whether the cancer cells are sensitive to certain particular hormones, and
- Personal preferences
In general, breast cancer stages range from 0 to IV. 0 may indicate a small and non-invasive cancer, while IV indicates that the cancer has spread to other areas of the body. Briefly, as per US National Cancer Institute , breast cancer is staged as follows:
- Stage 0 : The abnormal cancer cells are confined to their site of origin
- Stage I: The tumor is 2 centimeters in diameter or less, and has not spread outside the breast
- Stage II: The tumor may be up to 5 centimeters in diameter and may have spread to lymph nodes. Another criteria is that the tumor may be larger than 5 centimeters in diameter, but has not spread to surrounding lymph nodes
- Stage III: The tumor may be more than 5 centimeters in diameter and may have spread to several axillary lymph nodes, or to the lymph nodes near the breastbone. The cancer may also have spread to the breast skin/chest wall, causing ulcer-like sores, or a swelling
- Stage IV: The tumor has spread outside the breast and to other organs, such as the bones, liver, lungs, or brain, regardless of its size
If breast cancer is diagnosed, staging helps determine whether it has spread and which treatment options are best for the patient.
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Who Gets Invasive Ductal Carcinoma Of Breast
- Invasive Ductal Carcinoma of Breast is a very common type of breast cancer. Almost 70-80% of breast cancers are Ductal Carcinoma NOS types
- Middle-aged and older women past the age of 40 years are affected, though women over 65 years have the highest risk
- Although both women and men are capable of developing the condition, it is much more common in women
- All racial and ethnic groups are affected and no specific predilection is seen
- Developed countries show higher prevalence rate for breast cancer than developing countries average of 80 cases per 100,000 populations, as against 18 cases per 100,000 populations seen in the developing countries. Thus, America, Europe, Australia have greater incidences than Asia and Africa
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Treatment For Invasive Breast Cancer
Treatment for invasive breast cancer usually involves some combination of surgery, radiation therapy, chemotherapy, hormone therapy and/or HER2-targeted therapy.
The order of therapies and the specific treatments depend on the cancer stage and the characteristics of the tumor .
Learn more about treatment.
Types Of Invasive Breast Cancer
Two types account for about 90% of invasive breast cancer.
- Invasive ductal carcinoma . This is the most common type, making up about 80%. With IDC, cancer cells start in a milk duct, break through the walls, and invade breast tissue. It can remain localized, which means it stays near the site where the tumor started. Or cancer cells may spread anywhere in the body.
- Invasive lobular carcinoma . This type accounts for about 10% of invasive breast cancers. ILC starts in the lobules or milk glands and then spreads. With ILC, most women feel a thickening instead of a lump in their breast.
Some women may have a combination of both or a different type of invasive breast cancer.
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Invasive Breast Cancer And Staging
Whether or not invasive cancer cells are present can influence how breast cancer is staged after a diagnosis.
Breast cancer that remains isolated to the area in which it started and has not spread into healthy breast tissue is called cancer in situ. You may also see this referred to as non-invasive breast cancer or Stage 0 breast cancer.
When invasive cancer is detected, it can be staged as stage 1 through 4. Many of these stages also have subcategories.
Several factors are taken into consideration with the TNM staging system thats used for invasive breast cancer. This includes:
Other factors that can impact staging are:
There are different types of invasive breast cancer. Lets examine some of the most common ones in more detail.
How Is Invasive Mammary Carcinoma Diagnosed
Same Day Results
At the Johns Hopkins Breast Center, our breast specialists understand how quickly patients want results from a biopsy or scan if there is a suspicion of breast cancer. We follow strict guidelines for biopsies and pathology reports. Most of our patients will receive diagnosis immediately following their biopsy procedure, and a pathology confirmation within 24 hours.
Learn more about the steps of diagnosis, including:
- Digital mammography
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Invasive Ductal Carcinoma Nos
Invasive ductal carcinomas , a group of heterogeneous tumors that lack the morphological characteristics that would allow them to be classified as any specific histological types, account for up to 80% of all invasive breast cancers ). A tumor is classified as IDC NOS if the specific subtype comprises < 10% of the total tumor volume, and a tumor is classified as a mixed tumor if the specific subtype comprises 1090% of the total tumor volume. IDC NOS is frequently associated with ductal carcinoma in situ . The tumor cells are positive for low-molecular-weight cytokeratin , including CK8/18 and CAM5.2, and are generally immunoreactive to E-cadherin. The histological grading of IDC NOS has the most prognostic relevance.
Figure 1. Invasive ductal carcinoma, NOS, and special types of invasive breast cancers. IDCa, NOS. Invasive lobular carcinoma. Invasive mucinous carcinoma. Invasive metaplastic carcinoma. Invasive micropapillary carcinoma. Invasive carcinoma with medullary features.
Michael S. Sabel MD, FACS, in, 2009
Additional And Relevant Useful Information For Invasive Ductal Carcinoma Of Breast :
- Japan is an exception of a developed nation with lowered incidences of breast cancer, unlike European nations and America.
- Current studies have shown that aromatase inhibitors, medications that block estrogen hormonal effects in the body, reduce the risk of recurrence of breast cancer. Recent studies have shown that treatment using aromatase inhibitors can be given up to 10 years without affecting the quality of life of women
- Tumors that are negative for estrogen receptor, progesterone receptor, and HER2/neu have worse prognosis. Such tumors are called âtriple-negativeâ tumors
The following DoveMed website links are useful resources for additional information:
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What Is Invasive Papillary Carcinoma Of Breast
- Breast cancer is the most common type of cancer diagnosed in women. It is a type of cancer in which certain cells in the breast become abnormal, grow uncontrollably, and form a malignant mass . There are various types of breast cancers which include ductal carcinoma and lobular carcinoma
- Invasive Papillary Carcinoma of Breast is a specific type of invasive ductal carcinoma of breast that initially affects the milk ducts and moves on to involve other parts of the breast. A majority of this cancer type is observed in post-menopausal women
- The signs and symptoms of Invasive Papillary Carcinoma of Breast include lumps in the breast, swelling or skin thickening around the region of the lump, and change in breast profile. Complications from this cancer type include treatment side effects such as nausea, vomiting, and hair loss
- In order to treat Invasive Papillary Breast Carcinoma, the healthcare provider may use a combination of therapies that may include surgery, chemotherapy, radiation therapy and targeted therapy, depending on the stage of the tumor
- The prognosis of Invasive Papillary Carcinoma of Breast is generally much better than invasive ductal carcinomas. An early diagnosis and adequate treatment can significantly improve the outcome
How Is Invasive Papillary Carcinoma Of Breast Diagnosed
Invasive Papillary Breast Carcinoma may be diagnosed in the following manner:
- Complete physical examination with comprehensive medical and family history evaluation
- The following information may be sought by the healthcare provider:
- Family history of breast cancer and ovarian cancer
- Family history of BRCA 1 or BRCA 2 mutation
- History of pregnancy
- History of breastfeeding
- Prior history of breast cancer
- Prior history of breast trauma
- Prior history of breast biopsy/surgery history of any breast implantation may also be included
- History of radiation therapy
- History of chemotherapy
- History of hormonal therapy
- History of autoimmune disorders
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How Is Invasive Breast Cancer Treated
Different things will determine the type of breast cancer treatment your doctor recommends, including:
- Size of the tumor
- Results of lab tests done on the cancer cells
- Stage of the cancer
- Your age and general health
- If youâve been through menopause
- Your own feelings about the treatment options
- Family history
Special Types Of Invasive Breast Cancer
These are less common forms of invasive ductal breast cancer, and all have particular distinguishing features, which are seen under a microscope.
Pagets Disease of the Breast This rare type of breast cancer accounts for approximately 2% of all breast cancers and usually presents with a red, scaly or ulcerated nipple, sometimes accompanied by a burning sensation or discharge. The cancer cells accumulate in the ducts of the nipple but may extend out to the nipple surface. The skin changes sometimes extend to the areola but they first arise on the nipple. Pagets Disease is often initially confused with eczema or other skin conditions. A full-thickness skin biopsy taken from the nipple/areola is usually required for diagnosis.Occasionally the disease is confined solely to the nipple, but the majority of people with Pagets Disease will also have underlying DCIS or, in some cases, an invasive tumour in the breast.
Mucinous carcinoma This is a rare form of invasive ductal cancer in which cancer cells are surrounded by mucin, a principal component of mucous. It accounts for 2-3% of all breast cancers, and tends to occur in women over 60. It is extremely rare in men. It is generally less aggressive and less likely to spread to the lymph nodes than other types.
Micropapillary carcinoma This is an aggressive form of breast cancer with a high rate of lymph node involvement. The cells form in clusters with distinct clear spaces between them.
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What Are The Signs And Symptoms Of Invasive Papillary Carcinoma Of Breast
The signs and symptoms of Invasive Papillary Carcinoma of Breast may include:
- A lump in the breast or underarm area it is not unusual to find multiple masses in the breast
- Almost half of the tumors are centrally located in the breast
- Thickening or swelling of part of the breast change in the size or shape of the breast
- Enlarged axillary lymph nodes, observed in many women with the condition but this not due to the cancer spreading to the lymph nodes
- Inversion of the nipple
- Bloody discharge from the nipple is observed with this tumor type nipple discharge is seen in 1 in 4 cases
- Changes to the skin covering the breast or nipple area, including dimpling, irritation, redness, scaling, peeling, or puckering
- In some cases, pain in the breast
Prior Breast Health History
A history of breast cancer is associated with a 3- to 4-fold increased risk of a second primary cancer in the contralateral breast. The presence of any premalignant ductal carcinoma in situ or LCIS confers an 8- to 10-fold increase in the risk of developing breast cancer in women who harbor untreated preinvasive lesions.
A history of breast biopsy that is positive for hyperplasia, fibroadenoma with complex features, sclerosing adenosis, and solitary papilloma have been associated with a modest increase in breast cancer risk. In contrast, any diagnosis of atypical hyperplasia that is ductal or lobular in nature, especially in a woman under the age of 45 years, carries a 4- to 5-fold increased risk of breast cancer, with the increase rising to 8- to 10-fold among women with multiple foci of atypia or calcifications in the breast.
Benign breast lesions, including fibrocystic disease such as fibrocystic change without proliferative breast disease or fibroadenoma, have not been associated with increased risk.
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What Is Ductal Carcinoma In Situ
Ductal Carcinoma in Situ , also known as intraductal carcinoma, accounts for one of every five new breast cancer diagnoses. Its an uncontrolled growth of cells within the breast ducts. Its noninvasive, meaning it hasnt grown into the breast tissue outside of the ducts. The phrase in situ means in its original place.
DCIS is the earliest stage at which breast cancer can be diagnosed. Its known as stage 0 breast cancer. The vast majority of women diagnosed with it can be cured.
Even though its noninvasive, it can lead to invasive cancer. Its important that women with the disease get treatment. Research shows that the risk of getting invasive cancer is low if youve been treated for DCIS. If it isnt treated, 30% to 50% of women with DCIS will get invasive cancer. The invasive cancer usually develops in the same breast and in the same area as where the DCIS happened.
What Does It Mean If My Report On Ductal Carcinoma In Situ Mentions Estrogen Receptor Or Progesterone Receptor
ER and PR are special tests that the pathologist does that are important in predicting response of the DCIS to hormone therapy . Testing for ER is done for most cases of DCIS, but testing for PR is not typically needed. Results for ER and PR are reported separately and can be reported in different ways:
- Negative, weakly positive, positive
- Percent positive with something saying whether the staining is weak, moderate, or strong
Ask your doctor how these results will affect your treatment.
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Invasive Ductal Carcinoma Idc Or Infiltrating Ductal Carcinoma
Invasive Ductal Carcinoma or Infiltrating ductal carcinoma indicates that the cancer cells that are in the milk ducts are now beginning to infiltrate and replace the normal surrounding tissues of the duct walls.
Furthermore, the cancer cells have broken through the basement membrane of the duct and into the surrounding breast tissue, resulting in a mass. Invasive ductal carcinoma accounts for up to 80 % of all breast cancers.
Often the phrase invasive ductal carcinoma is used as a label for all carcinomas not otherwise designated as a recognizable type.
This page focuses on understanding the histopathology about invasive ductal carcinoma. However, we have a newerposton invasive cancers, including invasive ductal carcinoma, with up-to-date references, and general information.
Prognosis By Cancer Type
DCIS is divided into comedo and noncomedo subtypes, a division that provides additional prognostic information on the likelihood of progression or local recurrence. Generally, the prognosis is worse for comedo DCIS than for noncomedo DCIS .
Approximately 10-20% of women with LCIS develop invasive breast cancer within 15 years after their LCIS diagnosis. Thus, LCIS is considered a biomarker of increased breast cancer risk.
Infiltrating ductal carcinoma is the most commonly diagnosed breast tumor and has a tendency to metastasize via lymphatic vessels. Like ductal carcinoma, infiltrating lobular carcinoma typically metastasizes to axillary lymph nodes first. However, it also has a tendency to be more multifocal. Nevertheless, its prognosis is comparable to that of ductal carcinoma.
Typical or classic medullary carcinomas are often associated with a good prognosis despite the unfavorable prognostic features associated with this type of breast cancer, including ER negativity, high tumor grade, and high proliferative rates. However, an analysis of 609 medullary breast cancer specimens from various stage I and II National Surgical Adjuvant Breast and Bowel Project protocols indicates that overall survival and prognosis are not as good as previously reported. Atypical medullary carcinomas also carry a poorer prognosis.
Additionally, lymph node metastasis is frequently seen in this subtype , and the number of lymph nodes involved appears to correlate with survival.
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