Invasive Ductal Carcinoma Treatment
The most common form of breast cancer, invasive ductal carcinoma (IDC) accounts for approximately 80% of all diagnoses. The cancer originates in a milk duct, a tunnel through which milk flows from a milk-producing gland (lobule) to the nipple. As the tumor grows, cancerous cells may break through the wall of the duct and invade nearby lymph nodes and other tissues.
Prompt IDC treatment is important; if cancerous cells enter the lymphatic system or bloodstream, they can circulate throughout the body and spread to distant organs and tissues. As cancer spreads, it generally becomes more challenging to treat.
The optimal treatment approach for invasive ductal carcinoma can vary based on many factors, including the location, size and extent of the tumor and the patient’s overall health and preferences. Some options include:
Surgery for invasive ductal carcinoma
Breast cancer surgery continues to advance and improve. In addition to removing a tumor, surgical techniques can now be performed to lessen the emotional impact of losing all or part of a breast to cancer.
Surgical treatment for IDC may involve a:
- Lumpectomy – A surgeon removes the breast tumor along with a slim margin of surrounding healthy tissue for evaluation by a pathologist. Known as breast-conserving surgery, a lumpectomy is usually followed by radiation therapy to destroy any microscopic cancer cells that may remain in the breast tissue. This can help prevent a recurrence.
- Mastectomy – A surgeon removes all breast tissue, including the nipple and areola, the breast skin and the tissues that cover the chest muscles. Usually, the surgeon will also perform a sentinel lymph node biopsy to check for cancer spread. A mastectomy may be considered for treating large, multiple or aggressive invasive ductal tumors, or for the patient’s peace of mind. Some patients opt for breast reconstruction afterward.
Chemotherapy for invasive ductal carcinoma
Chemo is a systemic treatment in which powerful anti-cancer drugs are injected into a vein or taken by mouth in pill or capsule form. After entering the bloodstream, the medication circulates throughout the body to reach and damage widespread cancer cells.
Chemotherapy may be considered for treating:
- A large tumor that cannot be surgically removed
- Metastasized IDC
- Triple-negative IDC
- HER2- or neu-positive IDC
Additionally, chemotherapy may be administered before surgery to shrink a tumor and make it easier to remove, or after surgery to destroy residual cancer cells and help prevent a recurrence.
Radiation therapy for invasive ductal carcinoma
Radiation therapy involves the delivery of high-energy X-rays (photons) or particle beams directly to a tumor to damage the cancerous cells. In many cases, breast cancer surgery such as a lumpectomy or mastectomy is followed by radiation therapy to help prevent a recurrence.
There are several ways to deliver radiation therapy for the treatment of invasive ductal carcinoma, including:
- External whole-breast radiation with or without lymph node treatment – High-energy beams are generated by an external machine (accelerator) and precisely aimed at a tumor, cancerous mass or lymph node.
- External partial-breast irradiation – External beam radiation is delivered only to the area of the breast that has a high risk of cancer recurrence.
- Brachytherapy – Radioactive seeds or pellets are temporarily placed in or around a tumor site.
Found in and on the surface of some cancer cells, hormone receptors are proteins that bind to certain hormones, such as estrogen and progesterone, which in turn stimulate cell growth. If invasive ductal carcinoma tests positive for either type of hormone receptor, hormone therapy may be considered to lower the level of the respective hormone in the body and thereby prevent the cancer from growing. Common options include tamoxifen and aromatase inhibitors, which may be taken for several years after breast cancer surgery.
A form of precision medicine, targeted therapy involves the use of medications that home in on specific characteristics of cancer cells, such as proteins that control how the cells replicate and spread. For instance, HER2-positive invasive ductal carcinoma has a high level of the HER2 protein, which helps the cancer grow. HER2-targeted therapy is designed to prevent the HER2 receptors on the cancer cells from receiving growth signals.
Clinical trials for invasive ductal carcinoma
The landscape of breast cancer treatment continues to evolve. Through clinical trials, some patients have opportunities to access promising new treatments before those options become available in other settings. These long and meticulous research studies begin in a laboratory and progress through an extensive, multi-step testing process before the treatment is offered to the general public. Patient participants can benefit from groundbreaking therapies; at the same time, scientists can develop new standards of care and clinicians can gain a broader understanding of breast cancer and how to prevent, diagnose and treat it.
If a patient has the option to participate in an invasive ductal carcinoma clinical trial, the decision to proceed is highly personal and best made with the guidance of a physician who is familiar with the patient’s unique situation. In general, the physician will discuss the treatment in detail, explain what the patient can expect and describe the care the patient will receive. The patient will be encouraged to ask specific questions, such as how the study might affect their everyday life.
For some patients, a clinical trial is the best treatment option. Additionally, a clinical trial participant can feel good about contributing to the advancement of cancer research and the development of treatment options that will help future generations.
Benefit from world-class care at Moffitt Cancer Center
The multispecialty team in Moffitt’s Don & Erika Wallace Comprehensive Breast Program takes an individualized approach to invasive ductal carcinoma treatment. Our fellowship-trained surgeons focus exclusively on treating breast cancer patients, and we offer a full range of treatment options in one location, including a robust portfolio of clinical trials.