An Overview Invasive Ductal Carcinoma (IDC)

A.K.A. infiltrating carcinoma or invasive breast cancer

Infiltrating ductal carcinoma (IDC) is also known as infiltrating carcinoma or invasive breast cancer. This is the most common type of breast cancer. With IDC, cancer cells start growing in the milk ducts of the breast. As the tumor grows, it may spread beyond the ducts into surrounding tissues. Once cancer cells reach the lymph system or blood vessels, they may metastasize (spread) to other parts of the body.

What to Know About Invasive Ductal Carcinoma (IDC)

Lara Antal / Verywell

The term "invasive" means cancer cells have spread beyond the duct system into other parts of the breast. This does not always mean IDC has spread beyond the breasts, or even that it has invaded the lymph nodes or blood vessels. 

Healthcare providers use a staging system to describe how far cancer has spread within the body. For breast cancer, the stages are numbered from 0 to 4. Higher numbers indicate more extensive spread. Stage 0 breast cancer (carcinoma in situ) is the only non-invasive stage. All breast cancers from stages 1 to 4 are invasive. 

This article will discuss invasive ductal carcinoma, a type of breast cancer. It will review the prevalence, symptoms, causes and risk factors, diagnosis, treatment, and coping with this disease.

Types of Invasive Ductal Carcinoma

Most invasive ductal carcinomas are the general type. There are also four additional sub-types, and they are much less common:

  • Medullary ductal carcinoma: The tumor cells of this type look aggressive when examined with a microscope, but they are often slow-growing. They are named because they look similar to a part of the brain called the medulla. This tumor type is most common in women who are in their late 40s to early 50s. The BRCA1 gene raises the risk for this kind of tumor.
  • Mucinous ductal carcinoma: This is a less aggressive tumor where cancer cells are surrounded by a puddle of mucin (the main component of mucous). This cancer most often develops in women in their 60s and beyond.  
  • Papillary carcinoma: These are very rare kinds of IDC that have a tumor with “fingers” that grow out and reach toward nearby healthy cells. They most often occur in people after menopause. Sometimes the cells are abnormal and grow very quickly.
  • Tubular ductal carcinoma: This less aggressive, slow-growing tumor grows in very small tube shapes. It generally affects women in their early 50s. 

Prevalence

According to the American Cancer Society, about 80% of all breast cancers are IDC. This type of breast cancer can occur at any age, but many people are over the age of 55 at the time of diagnosis. The National Cancer Institute reports that a woman’s risk of breast cancer increases with age.

IDC is also the main cause of male breast cancers. The American Cancer Society estimates that about 1 in 833 men will be diagnosed with breast cancer.

Signs and Symptoms

Breast cancer usually doesn't cause symptoms. According to the American Cancer Society, when breast cancer causes symptoms, a new lump or mass is the most common symptom.

The American College of Physicians recommends mammograms as the best screening tool for breast cancer. Most importantly, get any routine screening recommended by your healthcare provider.

Your provider may also do a clinical breast exam or may recommend you complete a monthly breast self-examination (BSE). Medical guidelines are changing and BSE is not often recommended for cancer screening. However, self-examination of your breast can be helpful in other ways.   

A monthly BSE helps you to know what is normal for your breast tissue. Over time, you will become familiar with your breast health. Sometimes, you can able to recognize changes to the breast and identify breast cancer early. 

Some signs of breast cancer that may be found during a breast self-examination include:

  • Swelling in all or part of the breast
  • Skin irritation
  • Dimpling (having the bumpy texture of an orange peel)
  • Breast and/or nipple pain
  • Nipple retraction (pulled in rather than sticking out)
  • Red, scaly, and/or thick skin in the breast and/or nipple
  • Nipple discharge, other than milk
  • Lump near the nipple, beneath the areola, in the breast tissue, or in the underarm 

If you find changes to your breast or if you develop any of the issues listed, reach out to your healthcare provider for further evaluation.

Breast pain is most often due to a benign (noncancerous) condition. However, sometimes, it can be a symptom of breast cancer. Talk to your healthcare provider about any new or worsening breast pain.

Causes and Risk Factors

The underlying causes of IDC are not fully known. Scientists continue to study what makes a person more or less likely to develop breast cancer. There are some risk factors you can change, and some you cannot. 

Researchers think certain hormonal, environmental, and lifestyle factors increase a person’s risk for breast cancer. Smoking, birth control pills and hormone replacement, obesity, lack of exercise, and prior radiation to the chest have been associated with higher cancer risk. Other times, people develop breast cancer without such known risk factors.

There are some breast cancer risk factors that are not changeable. They are things you are born with or inherit from your parents.

This includes:

  • Being female: Breast cancer is more common in women
  • Being older: Breast cancer risk increases with age
  • Certain breast cancer genes: Breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2) are inherited tumor suppressor genes.
  • A family history of breast cancer

Your healthcare provider will review your risk factors with you and help you make decisions about your health choices and cancer screening.

Diagnosis

If you find a breast lump during your breast self-exam or a clinical exam, you need to have it properly checked out. Fortunately, 80% of all breast lumps are not cancer. Instead, they are often benign issues that may mimic cancer. For the other 20%, if breast cancer is caught early, your chances of survival are generally very good. 

The American College of Physicians (ACP) published clinical guidelines for people with an average risk for breast cancer without symptoms. Overall, the recommendation is for regular mammograms to screen for breast cancer.

In people considered at average risk who do not have symptoms of breast cancer, the recommendations change with age:

  • 40-49 years old: Current guidelines recommend starting annual screening mammograms at age 40.
  •  50-74 years old: Providers should offer screening mammograms every one to two years.
  • Age 75 and older: Stop screening if life expectancy is less than or equal to 10 years.

Clinical breast exam, breast ultrasound, and magnetic resonance imaging (MRI) are not recommended as initial screening tests. 

If your mammogram shows an area of concern, your healthcare provider may recommend that you have a breast biopsy. A biopsy is a procedure that involves obtaining a sample of the growth. There are several ways to obtain a biopsy sample, and your healthcare team will let you know which is recommended for you based on size, location, and other factors. 

The sample is examined with a microscope by a specialized doctor called a pathologist. 

A biopsy will help determine if the suspicious area is malignant (cancerous) or benign. Grading (aggressiveness of cancer) is based on how different the cells are from normal breast cells. The biopsy examination can identify the type of cells to determine the type of breast cancer. The biopsy can also be used to help guide treatment by identifying features of the tumor that may make it treatable with certain medications—such as hormone receptors or specific genes.

Breast Cancer Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Treatment

The goal of treating any breast cancer is to get rid of cancer cells and prevent any cancer from coming back. The return of cancer is called recurrence

There are multiple kinds of treatment for breast cancer, and they can be used in different combinations. Researchers are continuing to study what combination of treatments for IDC is most effective.

Breast cancer treatments may include: 

  • Surgery: A lumpectomy involves the removal of cancer and a small area of healthy tissue around it. A mastectomy removes the entire breast. 
  • Chemotherapy: Chemotherapy drugs may be used before surgery to shrink the tumor. It may also be given after surgery to prevent cancer cells from returning.
  • Radiation: Radiation therapy for breast cancer usually uses external X-ray beams to kill cancer cells. Radiation can be used before surgery, after surgery, or as the only treatment.
  • Hormone therapy: Certain medicines may be given if cancer cells have specific hormone receptors. For example, HER2 cancer cells are treated with targeted therapy drugs, such as Herceptin (trastuzumab). In addition, many drugs treat different kinds of hormone-sensitive breast cancers.

The goal of treatment is to give you the best possible outcome, so treatment plans are adjusted for each individual person.  

Considering Clinical Trials

Clinical trials use newly developed drugs to see if they work and how safe they are. These drugs are typically not approved for use by the general public. Joining a trial may be a way for you to try a treatment that isn’t available to everyone. Your healthcare provider can be a great source of information about which trial might work for your unique situation.

Follow-Up

Even after you have completed primary treatments for breast cancer, you will still see your oncologist for several years for check-ups. You may need to take hormone therapy for up to 10 years if the tumor was estrogen- or progesterone-sensitive.

You will continue to have mammograms on any breast tissue that you still have.

Bone density scans are usually recommended once you reach menopause to check for signs of bone loss. Osteopenia (thinning bone) and osteoporosis (weak bone) are more common when women have changes in estrogen—a common side effect of some breast cancer treatments.

Prognosis

Healthcare providers use the term prognosis to talk about your future outlook and survival. Different things influence a person’s prognosis with IDC, including:

  • Whether IDC is a new diagnosis or a recurrence
  • The stage of the cancer and whether it is confined to the breast or has spread to lymph nodes, other tissue, or organs
  • Hormone-receptor status
  • Treatment responses
  • Your age, overall health, and menopausal status (if female)

Your healthcare team will be able to give you more information about how treatable they expect your cancer to be. You will also likely have more tests along the way to see how your cancer is responding to the treatment.

Summary

Invasive ductal carcinoma is a very common type of breast cancer. Regular mammograms are the recommended way to screen for this kind of cancer. If you are diagnosed with IDC, your healthcare team will work together with you to make a plan to treat your cancer based on the size and location of the tumor, the extent of spread, and your overall health.

A Word From Verywell

If you have been diagnosed with IDC, the support you may need can come in many forms. For example, you may benefit from a close friend to vent to, a support group or therapist, or family members who offer practical help such as housework, childcare, or getting you to appointments. Know that reaching out and getting the care, love, and understanding you need is also important for your treatment process. For your part, do what you can to take care of yourself: eat healthy foods, keep moving your body, and focus on self-care.

Frequently Asked Questions

  • How long does it take invasive ductal carcinoma to spread?

    The time it takes for a tumor to grow to twice its size is called doubling time. Each type of cancer has an average doubling time that's impacted by many factors, including the effect of hormones on the tumor and tumor markers such as Ki-67. Tumors that grow faster are often called aggressive. Your healthcare team will let you know about the characteristics of your specific cancer. 

  • Is invasive ductal carcinoma life-threatening?

    Generally, invasive ductal carcinoma is considered a treatable type of cancer, especially when caught early and treatment is started right away. Overall, 90% of people are expected to live at least five years. The smaller and more contained the tumor, the higher the survival rate.

  • Is invasive ductal carcinoma hereditary?

    The American Cancer Society reports that 5%-10% of breast cancers are believed to be hereditary (passed from parents to children in the genes). Certain genes are known to increase the risk of breast cancer. Talk to your doctor about your family health history to see if testing for BRCA1 or BRCA2 is right for you.

  • What is the survival rate of invasive ductal carcinoma?

    The National Cancer Institute reports a 90% five-year relative survival rate for females with breast cancer. There are some differences in breast cancer survival rates depending on the age at diagnosis, the stage of cancer, and the hormone receptor status. Race is also a factor in survival. Screening and early intervention for breast cancer typically give the best chance for survival. 

Originally written by
Pam Stephan
Pam Stephan is a breast cancer survivor.
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