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MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 53,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.
Are you living with invasive ductal carcinoma? Share your experiences in the comments below, or start a conversation by posting on MyBCTeam.
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. It’s 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. It’s 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. It’s 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 Are The Possible Complications Of Invasive Ductal Carcinoma Of Breast
The complications of Invasive Ductal Carcinoma of Breast may include:
- Emotional distress due to the presence of breast cancer
- Metastasis of the tumor to local and regional sites
- Side effects of chemotherapy, which may include nausea, vomiting, hair loss, decreased appetite, mouth sores, fatigue, low blood cell counts, and a higher chance of developing infections
- Side effects of radiation therapy that may include sunburn-like rashes, where radiation was targeted, red or dry skin, heaviness of the breasts, and general fatigue
- Lymphedema may occur after surgery or radiation therapy, due to restriction of flow of lymph fluid resulting in a build-up of lymph. It may form weeks to years after treatment that involves radiation therapy to the axillary lymph nodes
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Side Effects And Complications
Its important to tell your oncologist about all symptoms, even if they seem minor. Your healthcare team will work with you to ease side effects and deal with complications.
What If My Report On Ductal Carcinoma In Situ Mentions Margins Or Ink
When the entire area of DCIS is removed, the outside surface of the specimen is coated with ink, sometimes even with different colors of ink on different sides of the specimen. The pathologist looks at slides of the DCIS under the microscope to see how close the DCIS cells get to the ink . If DCIS is touching the ink , it can mean that some DCIS cells were left behind, and more surgery or other treatments may be needed. Sometimes, though, the surgeon has already removed more tissue to help make sure that this isnt needed. If your pathology report shows DCIS with positive margins, your doctor will talk to you about what treatment is best.
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Invasive Ductal Cancer With Central Necrosis
Necrosis refers to the debris left behind when cells die. In the context of a suspected breast cancer tumor doctors usually consider necrosis as an indicator of a more aggressive breast carcinoma.
It is quite common to see cell necrosis in mature invasive breast cancers. However, in the case of central necrosis, when the necrosis collects in a central location doctors commonly associate this with comedo DCIS or comedo carcinoma and notinfiltrative breast cancer.
Grading Breast Cancer Cells
Three cancer cell features are studied and each is assigned a score. The scores are then added to get a number between 3 and 9 that is used to get a grade of 1, 2, or 3, which is noted on your pathology report. Sometimes the terms well differentiated, moderately differentiated, and poorly differentiated are used to describe the grade instead of numbers:
- Grade 1 or well differentiated . The cells are slower-growing, and look more like normal breast tissue.
- Grade 2 or moderately differentiated . The cells are growing at a speed of and look like cells somewhere between grades 1 and 3.
- Grade 3 or poorly differentiated . The cancer cells look very different from normal cells and will probably grow and spread faster.
Our information about pathology reports can help you understand details about your breast cancer.
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Just Diagnosed Today Grade 2 Invasive Ductal
I guess I am just looking to find someone who has been on or is just starting on this jourbey that no one really wants to take.
I have just been diagnosed this afternoon with Grade 2 Invasive Ductal Carcinoma. ER+/PR+ , but no results back on the HER2 or any idea of stage.
I know that my lumo is 2ccm by 1.2cm and so far looks to be well contained, no lymphovasuclar involvement evident yet which is good and my chest xray is clear.
I am seeing the consultant on Friday morning and my breast cancer nurse says that the treatment plan so far is a lumpectomy with a sentinal node biopsy which will probably take place next week as a day surgery patient.
Are there any questions I should ask that you who have been through it all or are going through it can advise?
It all seems relativeky straightfoward so far and I feel strangely calm after a week of waiting for the results.
When do they normal advise you of what drugs, chemp, radio therapy you may need?
This forum has kept me the right side of madness this past week so thank you to you all
Thanks so much Kazza
I’m only 40 so went as a found a lump which the nurse at the GP practice initially thought was nothing to worry about. I am so pleased that they still referred me, non-urgently, for a mammogram and ultrasound otherwise who knows how long it would have been before it was picked up.
Did you have chemo or radiotherapy as well as the letrozole?
What Is Stage 1 Breast Cancer
Stage 1 breast cancer is the earliest stage of invasive breast cancer. The breast cancer has spread from its original location to the surrounding tissue but it is still contained in a relatively small area.
If you are diagnosed with Stage 1 breast cancer, this means that the tumour is less than 2 centimetres in size. No cancer cells have been found in the lymph nodes or other parts of the body at this stage.
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What Does It Mean If My Report Mentions Paget Disease
Paget disease is when cells resembling the cells of ductal carcinoma in situ are found in the skin of the nipple and the nearby skin . Paget disease of the nipple is usually associated with DCIS or invasive carcinoma in the underlying breast tissue. If Paget disease is found on needle or punch biopsy, more tissue in that area usually needs to be removed with the goal of entirely removing the area of Paget disease. Talk to your doctor about the best treatment for you.
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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Stage 1 Or 2 Early Breast Cancer
Stage 1 and 2 breast cancer refers to invasive breast cancer that is contained within the breast, and may or may not have spread to the lymph nodes in the armpit. These stages are also known as early stage breast cancer.
At Stage 1 and 2, some cancer cells may have spread outside the breast and armpit area, but at this stage these cannot be detected.
How Grade Affects Treatment Options
Your treatment team will consider the grade of your cancer when deciding which treatment to offer you.
If you have grade 3 breast cancer, youre more likely to be offered chemotherapy. This is to help destroy any cancer cells that may have spread as a result of the cancer being faster growing.
Chemotherapy is less likely for grade 1 and grade 2 cancers.
The grade of your cancer alone will not determine what treatment youre offered. Your treatment team will consider the grade alongside all other information about your cancer when deciding on the best treatment options for you.
Find out more about breast cancer and prognosis.
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What Is A Breast Cancers Grade
Cancer cells are given a grade when they are removed from the breast and checked in the lab. The grade is based on how much the cancer cells look like normal cells. The grade is used to help predict your outcome and to help figure out what treatments might work best.
A lower grade number usually means the cancer is slower-growing and less likely to spread.
A higher number means a faster-growing cancer thats more likely to spread.
What Is Invasive Lobular Carcinoma
In This Article
Invasive lobular carcinoma is a cancerous development commencing at the lobules of the breast. Lobules of the breast are milk-carrying ducts, which are extending throughout the breast tissue.
The invasive nature of this carcinoma has a tendency to spread from lobules to adjoin lymph nodes, breast tissues, and distant organs. It is one of the most common types of breast cancer.
Alternatively, Invasive lobular carcinoma is also termed as infiltrating lobular carcinoma1,2.
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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:
What Is The Significance Of The Stage Of The Tumor
The stage of a cancer is a measurement of the extent of the tumor and its spread. The standard staging system for breast cancer uses a system known as TNM, where:
- T stands for the main tumor
- N stands for spread to nearby lymph nodes
- M stands for metastasis
If the stage is based on removal of the cancer with surgery and review by the pathologist, the letter p may appear before the T and N letters.
The T category is based on the size of the tumor and whether or not it has spread to the skin over the breast or to the chest wall under the breast. Higher T numbers mean a larger tumor and/or wider spread to tissues near the breast. Since the entire tumor must be removed to learn the T category, this information is not given for needle biopsies.
The N category indicates whether the cancer has spread to lymph nodes near the breast and, if so, how many lymph nodes are affected. Higher numbers after the N indicate more lymph node involvement by cancer. If no nearby lymph nodes were removed to be checked for cancer spread, the report may list the N category as NX, where the letter X is used to mean that the information is not available .
The M category is usually based on the results of lab and imaging tests, and is not part of the pathology report from breast cancer surgery. In a pathology report, the M category is often left off or listed as MX .
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What Are The Causes Of Invasive Ductal Carcinoma Of Breast
The exact cause of development of Invasive Ductal Carcinoma of Breast is currently not clearly known.
- Studies have shown that such tumors may be caused by hormonal influence
- Certain gene mutations have also been reported in the tumors. Research is being performed to determine how these mutations contribute to the formation of the tumors
Additional Types Of Invasive Ductal Carcinoma:
There are four types of invasive ductal carcinoma that are less common:
- Medullary Ductal Carcinoma This type of cancer is rare and only three to five percent of breast cancers are diagnosed as medullary ductal carcinoma. The tumor usually shows up on a mammogram and it does not always feel like a lump rather it can feel like a spongy change of breast tissue.
- Mucinous Ductal Carcinoma This occurs when cancer cells within the breast produce mucous, which also contains breast cancer cells. The cells and mucous combine to form a tumor. Pure mucinous ductal carcinoma carries a better prognosis than more common types of IDCs.
- Papillary Carcinoma This is a very good prognosis breast cancer that primarily occur in women over the age of 60.
- Tubular Ductal Carcinoma This is a rare diagnosis of IDC, making up only two percent of diagnoses of breast cancer. The name comes from how the cancer looks under the microscope like hundreds of tiny tubes. Tubular breast cancer has an excellent prognosis.
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Stage 1b Breast Cancer Means One Of The Following Descriptions Applies:
Lymph nodes have cancer evidence with small clusters of cells between the approximate size of a pinprick to the approximate width of a grain of rice .
AND EITHER No actual tumor is found in the breast.
OR The tumor is smaller than the approximate size of a peanut .
Similar to stage 0, breast cancer at this stage is very treatable and survivable. When breast cancer is detected early, and is in the localized stage , the 5-year relative survival rate is 100%.
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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Additional Immunohistochemical Markers For Infiltrative Ductal Carcinoma With Central Necrosis
Most invasive breast cancers will lack both a basement membrane and myoepithelial cells.
However, in actuality, there are many breast cancers that produce basement membrane components.
In addition, there are several invasive cancer that have myoepithelial cell elements. So, when trying to determine if a suspicious breast cancer lesion featuring central necrosis is comedo DCIS or an infiltrative breast carcinoma with central necrosis, there are a number of myoepithelial markers that may help.
Common myoepithelial cell markers include:-
- S-100, smooth muscle actine
- SMM-HC, Calponin: Is probably the most specific myoepithelial cell marker
- HMW-CK. SMM-HC .
- CD10, p63
- P63: Is quite a useful marker in breast cancer differentiation because it stains the myoepithelial nuclei only, and also has high sensitivity and specificity.