Invasive Ductal Carcinoma Surgery
Invasive ductal carcinoma (IDC) is a type of breast cancer that originates in a milk duct and spreads to nearby tissues, such as the axillary lymph nodes under the arm. Over time, the cancerous cells may enter the lymphatic system or bloodstream and travel (metastasize) to distant areas of the body. IDC accounts for approximately 80% of breast cancer cases. It is also the most common type of male breast cancer.
When detected early, invasive ductal carcinoma can often be treated effectively. In general, as the cancer spreads, it becomes more challenging to treat. The optimal treatment approach can vary based on several factors, including the location, size, stage and extent of the tumor and the patient’s overall health and preferences. In many cases, surgery is performed to remove the cancerous tissues. Chemotherapy or radiation therapy 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.
Surgical treatment options for invasive ductal carcinoma include:
If a breast tumor is relatively small and can be eliminated with the removal of one-third or less of the breast tissue, a lumpectomy may be considered. When performing this procedure, the surgeon removes the breast tumor or mass along with a slim margin of surrounding healthy tissue. Because the surgeon attempts to keep the natural breast intact by preserving as much healthy tissue as possible, a lumpectomy is commonly referred to as breast-conserving surgery. In comparison, a mastectomy involves removing the entire breast that contains the tumor. Technically, a lumpectomy is a partial mastectomy.
During a lumpectomy, the surgeon may also perform a sentinel node mapping and biopsy procedure to determine if the cancer has spread beyond the breast. To do so, the surgeon will inject a harmless blue dye or a weak radioactive solution near the nipple. Using a special device, the surgeon will observe the flow of lymph drainage from the breast, then identify the sentinel lymph node(s), which are the first tissues to which cancerous cells are most likely to spread from the breast. After making a small incision under the arm, the surgeon will remove the sentinel lymph node(s) for further evaluation by a pathologist, who will view the tissues under a microscope to determine if they contain cancerous cells. If so, additional lymph nodes may be removed during a follow-up procedure.
In most cases, a lumpectomy is followed by radiation therapy to destroy any microscopic cancer cells that may remain in the breast tissue and help prevent a recurrence.
There are several types of mastectomy procedures. The most common is a total mastectomy, which involves removing 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.
Another option is a modified radical mastectomy, which involves removing all breast tissue, including the nipple and areola, the breast skin, the tissues that cover the chest muscles and most of the axillary lymph nodes.
When possible, some women opt for a nipple-sparing mastectomy, which involves removing all breast tissue and leaving the nipple, areola and breast skin intact. Another option is a skin-sparing mastectomy, which involves removing all breast tissue, the nipple and areola, and leaving the breast skin intact. In either case, the breast can then be immediately reconstructed with tissue expanders, breast implants or tissue flaps, which can produce a good cosmetic result.
A unilateral or single mastectomy involves the removal of one breast; a bilateral or double mastectomy involves the removal of both breasts. The latter procedure may be considered if there is invasive ductal carcinoma in both breasts or the patient has a high risk of developing a second breast cancer due to a strong family history or an inherited gene mutation that has been linked to breast cancer, such as a harmful mutation in breast cancer gene 1 (BRCA1) or breast cancer gene 2 (BRCA2). The decision to undergo a mastectomy is highly personal. Even if a unilateral mastectomy is an option, some patients opt for the peace of mind of a bilateral mastectomy.
Benefit from world-class care at Moffitt Cancer Cente
The fellowship-trained surgeons in Moffitt’s Don & Erika Wallace Comprehensive Breast Program have helped thousands of patients fight breast cancer by performing innovative surgical techniques and state-of-the-art procedures. Moffitt has earned an outstanding reputation as a leader in complex cancer surgery, and our surgeons have extensive experience and highly refined expertise.
If you would like to learn more about invasive ductal carcinoma surgery, you can request an appointment with an expert at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.