Infiltrating ductal carcinoma is a type of invasive breast cancer that accounts for nearly 75% of all breast cancers diagnosed each year.
Its management can be more delicate than that of in situ cancer and require more aggressive treatments, but its prognosis remains very positive, with a 5-year net survival rate of around 80%.
Despite these encouraging data, invasive ductal carcinoma should not be taken lightly: each woman should contact her doctor to develop a screening and monitoring strategy adapted to her level of risk and regularly perform breast self-examination.
Surveillance is, in fact, a key focus in the fight against breast cancer. Ductal carcinoma is always better managed when it is diagnosed early.
What is invasive ductal carcinoma?
Invasive ductal carcinoma is an invasive breast cancer, that is, a malignant tumor that extends beyond its primary site of development and infiltrates the tissues that surround it.
Breast cancer is a malignant lesion that arises from an anarchic proliferation of certain cells. These will then form a mass (tumor), spread, invade neighboring tissues, and, in the absence of treatment, form metastases capable of colonizing any organ of the body.
There are different types of breast tumors, and ductal carcinoma is – by far – the most common. It is a tumor that develops from the cells of the milk ducts of the breast.
When the cancer remains localized in the tissues of the lactiferous duct where it originally developed, it is called ductal carcinoma in situ. When the tumor extends outside the tissues of the duct, it is called invasive ductal carcinoma.
Diagnosis of invasive ductal carcinoma
Infiltrating ductal carcinoma is often diagnosed during a mammogram or breast ultrasound scheduled as part of a screening strategy or performed during a consultation motivated by visible symptoms observed or a self-palpation examination of the patient.
The first step in diagnosis is based on a clinical examination and anamnesis, which always precede medical imaging examinations.
When breast cancer is suspected, but mammography or breast ultrasound cannot locate a lesion, other types of medical imaging tests may be considered (scanner, MRI, etc.).
As soon as an abnormality is detected by medical imaging, a breast biopsy will be performed. This examination consists of taking fragments of the abnormality to examine the cells under a microscope.
This analysis (the anatomopathological examination) consists of evaluating the anatomy of the cells to establish their malignant potential and, if necessary, to determine the type of cancer detected and to look for characteristics allowing the probable response of the cancer to different treatments to be assessed.
Also, the diagnostic stage of invasive ductal carcinoma is crucial in the management of breast cancer and is not limited to identifying the disease.
It aims to collect a large amount of information that will allow a multidisciplinary medical team to develop a personalized prognosis and treatment protocol for each patient.
Treatments for invasive ductal carcinoma
Treatment of invasive ductal carcinoma is always personalized according to each patient’s profile, wishes, and characteristics of their tumor. It is therefore normal to see a treatment protocol vary greatly from one patient to another.
In most cases, oncological surgery remains the first-line treatment when feasible. This procedure consists of surgically removing the cancerous tumor, as well as a margin of healthy tissue around it.
Depending on multiple parameters, including the aggressiveness of the cancer, the patient’s profile, the level of risk of recurrence, or the probable response of the disease to adjuvant treatments, this margin of healthy tissue can be more or less significant, going as far as removal of the breast in its entirety (mastectomy).
Complementary treatments are commonly administered in addition to cancer surgery.
Neoadjuvant treatments, administered before surgery, aim to facilitate the procedure and/or reduce the risks of cancer cells spreading throughout the body during the operation.
Adjuvant treatments, administered after surgery, aim to ensure the destruction of the tumor to reduce the risk of residual cancer cells surviving and causing a recurrence.
Radiation therapy, chemotherapy, and hormonal therapy are among the most common treatments associated with the surgical removal of invasive ductal carcinoma. Other types of treatments, such as targeted therapies or immunotherapy, may also be indicated.
Infiltrating ductal carcinoma is typically more worrisome than the in situ form of this disease, but it is now successfully treated in many patients.
Although the news of this disease can be anxiety-provoking, it is essential not to give up. Many treatment options exist, and their effectiveness is increasing with the progress of oncological medicine.
