Invasive Ductal Carcinoma
Disease Details
Family Health Simplified
- Description
- Invasive ductal carcinoma (IDC) is a type of breast cancer that begins in the milk ducts and spreads to surrounding breast tissues.
- Type
- Invasive ductal carcinoma (IDC) is a type of breast cancer. It is generally not inherited in a straightforward Mendelian manner. However, genetic mutations such as BRCA1, BRCA2, and others may increase the risk of developing IDC. These mutations can be passed down through families, but the majority of IDC cases are sporadic, meaning they occur without a family history of the disease.
- Signs And Symptoms
- In most cases breast cancers are asymptomatic and are detected by routine clinical screening exams. In about 30% of cases a breast mass may be felt. The mass will not fluctuate with the menstrual period. Changes to the overlying skin including dimpling, pinching, orange peel-like texture, or nipple retraction may be seen. Non-healing ulcers can form in advanced disease, and were more common historically prior to modern medical care.Metastatic lesions from breast cancer may produce symptoms according to that organ system. The most common sites for metastasis are the bone, lung, liver, and brain. Skin metastases most commonly extend to the skin overlying the mass, but may spread to the axilla or more distant areas. Metastasis to adjacent lympatics may produce palpable masses in the axilla or an orange peel-like texture of the skin of the effected breast.
- Prognosis
-
While prognosis in invasive carcinoma NST is difficult to predict, there are some prognostic factors that help estimate survival. The factors included here tend to be generalizable to most breast cancers, and further information can be found in the main articles on breast cancer and breast cancer screening.
The prognosis of ductal carcinomas in general depend, in part, on its histological subtype. Mucinous, papillary, cribriform, and tubular carcinomas have longer survival, and lower recurrence rates. The prognosis of the most common form of invasive carcinoma NST is intermediate. Regardless of the histological subtype, the prognosis of IDC depends also on tumor size, presence of cancer in the lymph nodes, histological grade, presence of cancer in small vessels (vascular invasion), expression of hormone receptors and of oncogenes like HER2/neu.
Histologic factors associated with worse prognosis include high histologic grade, hormone receptor negativity, and HER2 negativity. Regarding genetic risk factors, BRCA1-associated breast cancers may have higher rates of lung and brain metastases but a lower rate of bone metastases. Cases detected by screening have favorable survival compared to cases that present clinically.White women have the highest rate of breast carcinoma, followed by Black, Asian/Pacific Islander, and Hispanic women. However, Black women are most likely to have greater severity of disease and triple-receptor negativity at time of diagnosis. Compared to other populations, they tend to have reduced chance of cure and a shorter survival after diagnosis if unable to be cured.In 2003, one study found the five-year survival rate of invasive carcinoma NST was approximately 85%. In general, greater tumor size and presence of lymph node metastasis predicts higher risk of recurrence after initial diagnosis and treatment. In one study, the lifetime risk of recurrence was 20% for smaller (<2 cm) tumors without lymph node metastasis. Larger tumors without lymph nodes had 38% risk of recurrence. Presence of lymph nodes in tumors of any size showed 62% and 86% risk of recurrence in patients with 1-3 and >4 positive lymph nodes, respectively. Another study showed “90% of recurrences occurred within 9, 7, and 5 years for patients with grades 1, 2, and 3 tumors, respectively. The rate of death due to breast carcinoma was also influenced by grade, with 90% occurring in 40, 13, and 8 years among patients with grades 1, 2, and 3 tumors, respectively.” - Onset
- "Invasive ductal carcinoma (IDC) is the most common type of breast cancer, typically developing in women over the age of 55, though it can occur at any age. This cancer starts in the milk ducts and then invades the surrounding breast tissue."
- Prevalence
- Invasive ductal carcinoma (IDC) is the most common type of breast cancer, accounting for about 80% of all breast cancer diagnoses. It typically occurs in women, but can also affect men, though at a much lower rate.
- Epidemiology
- Invasive carcinoma NST is one of the most common types of all breast cancers, accounting for 55% of breast cancer incidence. Of the invasive breast cancers, invasive carcinoma NST accounts for up to 75% of cases. It is also the most common form of breast cancer occurring in men, accounting for 85% of cases.The incidence of ductal carcinomas as a whole is 86.3 cases per 100,000 women, with the incidence increasing sharply for women over 40 years of age and peaking at 285.6 cases per 100,000 for women between 70 and 79. This incidence has decreased slightly over time. Incidence of diagnosed cases is highest among White and non-Hispanic women, followed by Black and Hispanic women.
- Intractability
- Invasive ductal carcinoma (IDC) is not inherently intractable. It is one of the most common types of breast cancer and its prognosis depends on various factors such as the stage at diagnosis, tumor size, hormone receptor status, HER2 status, and the patient's overall health. Treatment options include surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy. Early detection and advances in treatment have significantly improved outcomes for many patients. However, if diagnosed at a late stage or if resistant to treatment, the disease can be more challenging to manage.
- Disease Severity
- Invasive ductal carcinoma (IDC) is a type of breast cancer that begins in the milk ducts and invades surrounding tissue. Its severity can vary widely depending on several factors including the tumor grade, stage at diagnosis, hormone receptor status, HER2 status, and overall health of the patient. Early-stage IDC, where the cancer is limited to the breast or nearby lymph nodes, generally has a better prognosis and is more treatable. Advanced-stage IDC, which has spread to other parts of the body, is more challenging to treat and has a lower survival rate. Treatment options and outcomes often depend on the individual characteristics of the cancer and the patient's response to therapy.
- Healthcare Professionals
- Disease Ontology ID - DOID:3008
- Pathophysiology
-
Invasive ductal carcinoma (IDC) is the most common type of breast cancer. The pathophysiology of IDC involves the following processes:
1. **Cellular Origin**: IDC originates in the epithelial lining of the ducts in the breast tissue, specifically in the milk ducts.
2. **Genetic Mutations**: Mutations in genes such as BRCA1, BRCA2, TP53, and others contribute to abnormal cell growth. These mutations can be inherited or acquired.
3. **Tumor Formation**: Abnormal cells proliferate uncontrollably, forming a primary tumor within the ductal system.
4. **Invasion**: As the tumor grows, it breaches the ductal walls, invading the surrounding breast stroma and potentially spreading to adjacent tissues.
5. **Angiogenesis**: The tumor stimulates the growth of new blood vessels to supply the rapidly dividing cancer cells with necessary nutrients and oxygen.
6. **Metastasis**: Cancer cells can detach from the primary tumor, enter the lymphatic system or bloodstream, and spread to distant organs, forming secondary tumors.
Understanding these processes is crucial for diagnosing, treating, and managing IDC effectively. - Carrier Status
- Carrier status is generally not applicable for invasive ductal carcinoma. Invasive ductal carcinoma is a type of breast cancer that starts in the milk ducts and then invades surrounding tissues. It is primarily a condition that develops, rather than one that is carried like a genetic trait. However, certain genetic mutations (such as BRCA1 and BRCA2) can increase the risk of developing this cancer.
- Mechanism
-
Invasive ductal carcinoma (IDC) is the most common type of breast cancer. Here is the information regarding its mechanisms and molecular mechanisms:
**Mechanism:**
Invasive ductal carcinoma begins in the milk ducts of the breast. Once the cancer cells break through the ductal walls and invade the surrounding breast tissue, it is classified as invasive. The disease can spread to nearby lymph nodes and other parts of the body through the bloodstream or lymphatic system.
**Molecular Mechanisms:**
1. **Genetic Mutations:** IDC is often associated with specific genetic mutations, including those in the BRCA1 and BRCA2 genes, which are crucial for DNA repair mechanisms. Mutations in these genes can lead to genomic instability and carcinogenesis.
2. **Growth Factor Signaling:** Overexpression of growth factors like HER2 (human epidermal growth factor receptor 2) can drive the proliferation of cancer cells. HER2-positive IDCs tend to be more aggressive.
3. **Hormone Receptors:** Many IDC tumors express estrogen receptors (ER) and progesterone receptors (PR). Hormones like estrogen and progesterone can promote tumor growth in these cases. These tumors are often responsive to hormone therapy.
4. **Tumor Suppressor Genes:** Loss of function of tumor suppressor genes such as TP53 (encoding the p53 protein) and PTEN can result in unchecked cell division and tumor growth.
5. **Epigenetic Changes:** Aberrant methylation of DNA and modifications of histones can lead to the silencing of tumor-suppressor genes and activation of oncogenes, contributing to the development and progression of IDC.
6. **Angiogenesis:** Tumors can stimulate the formation of new blood vessels (angiogenesis) to supply the growing cancer with nutrients and oxygen. Vascular endothelial growth factor (VEGF) plays a notable role in this process.
7. **Cell Adhesion and Invasion:** Loss of cell adhesion molecules (e.g., E-cadherin) facilitates detachment from the primary tumor and invasion into surrounding tissue. Matrix metalloproteinases (MMPs) help degrade extracellular matrix components, aiding in tissue invasion and metastasis.
Understanding these mechanisms is crucial for developing targeted therapies and improving treatment outcomes for patients with IDC. - Treatment
-
The treatment of invasive carcinoma NST is often similar to management plans for other invasive breast carcinomas. The treatment options offered to an individual patient are determined by the form, stage and location of the cancer, and also by the age, history of prior disease and general health of the patient. Not all patients are treated the same way.
Management options for patients with invasive breast carcinomas include surgery, radiotherapy, and systemic adjuvant medical therapy. Surgical treatment ranges from radical mastectomy to breast conserving procedures such as lumpectomy. Patients at risk for local recurrence of disease may be offered radiotherapy. Patients at risk for systemic disease may be offered chemotherapy, and those whose tumors test positive for certain hormone receptor or genetic markers may be offered specific adjuvant medical therapies. Selective estrogen receptor modifying drugs (e.g., tamoxifen) or aromatase inhibitors (e.g., anastrozole) may be offered to those with estrogen or progesterone receptor positive tumors. HER2-positive tumors may be treated with the targeted medical therapy (e.g., trastuzumab).
Treatment of non-metastatic invasive breast cancer can vary based on staging, usually early stage (stages I and II) versus locally advanced (stage III). Patients with early stage disease may be offered surgery, including breast conserving therapy. This may be followed by radiotherapy for those at risk of local recurrence or systemic adjuvant medical therapy for those at risk of distant metastasis. Patient with locally advanced invasive breast cancer may be offered neoadjuvant systemic therapy and evaluated for tumor response prior to surgery, radiation, and adjuvant therapy.Prophylactic treatment may be an option for those with genetic predisposition to breast cancer. The National Comprehensive Cancer Network (NCCN) guidelines recommend bilateral prophylactic mastectomy and bilateral salpingo-oophorectomy for women who are carriers of germline BRCA1/2 mutation. At the age of 35 to 40 years, or once childbearing is completed, the procedure is recommended for risk reduction purposes. The NCCN states such management has led to reduced risk of breast carcinoma by 90% in this group. - Compassionate Use Treatment
-
For invasive ductal carcinoma (IDC), compassionate use treatments and off-label or experimental treatments might include:
1. **Targeted Therapy**: Off-label use of drugs like PARP inhibitors which are usually approved for other cancer types but might show promise in IDC with certain genetic markers (e.g., BRCA mutations).
2. **Immunotherapy**: Experimental treatments such as immune checkpoint inhibitors (e.g., pembrolizumab) are being studied for their efficacy in treating IDC, especially in cases where the cancer expresses PD-L1.
3. **Clinical Trials**: Participation in clinical trials for new drugs, combinations of treatments, or novel approaches like CAR-T cell therapy that are not yet approved but show potential in early-stage research.
4. **Compassionate Use Programs**: Access to drugs that are still in the experimental stage but have shown promise in early trials, provided on a compassionate use basis when standard treatments are ineffective or unavailable.
5. **Hormonal Therapy**: Off-label use of hormone-blocking drugs such as Fulvestrant in cases where patients have hormone receptor-positive IDC and other treatments have failed.
Patients should consult with their oncologist to explore these options, considering their specific medical condition and the potential risks and benefits associated with experimental or off-label treatments. - Lifestyle Recommendations
-
For invasive ductal carcinoma (IDC), lifestyle recommendations can support overall health and potentially improve outcomes:
1. **Healthy Diet:** Emphasize a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Limiting red and processed meats, refined sugars, and alcohol can be beneficial.
2. **Regular Exercise:** Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week, along with strength training exercises.
3. **Maintain a Healthy Weight:** Achieve and maintain a healthy weight to reduce the risk of cancer recurrence and other health issues.
4. **Limit Alcohol Consumption:** If you drink alcohol, do so in moderation. The American Cancer Society suggests no more than one drink per day for women and two for men.
5. **Quit Smoking:** If you smoke, seek resources to help you quit, as smoking can worsen cancer outcomes and general health.
6. **Manage Stress:** Incorporate stress-reducing practices such as meditation, yoga, or deep breathing exercises.
7. **Follow Medical Advice:** Adhere to the treatment plan and attend all follow-up appointments. Communicate openly with healthcare providers about any side effects or concerns.
8. **Support Networks:** Engage with support groups or counseling services for emotional and psychological support.
Following these lifestyle recommendations can complement medical treatments and improve overall well-being for individuals with invasive ductal carcinoma. - Medication
-
Invasive ductal carcinoma (IDC) is a common type of breast cancer. Treatment typically involves a combination of surgery, chemotherapy, radiation therapy, hormone therapy, and targeted therapy. The specific medication regimen depends on various factors such as the stage of cancer, hormone receptor status, and HER2 status. Common medications include:
- **Hormone therapy:** Tamoxifen, aromatase inhibitors (letrozole, anastrozole, exemestane)
- **Chemotherapy:** Doxorubicin, cyclophosphamide, paclitaxel, docetaxel
- **Targeted therapy:** Trastuzumab (Herceptin), pertuzumab, neratinib (for HER2-positive IDC)
Each patient's treatment plan is tailored to their specific needs. It is important to discuss the best options with a healthcare provider. - Repurposable Drugs
-
Research into repurposable drugs for invasive ductal carcinoma (IDC) is ongoing. Some drugs originally developed for other conditions have shown potential in treating IDC due to their anticancer properties. These include:
1. **Metformin**: Primarily used for type 2 diabetes, it has shown antiproliferative effects on cancer cells.
2. **Aspirin**: An anti-inflammatory agent that may reduce the risk of cancer metastasis and recurrence.
3. **Statins**: Commonly prescribed for lowering cholesterol, these drugs may have a role in inhibiting tumor growth.
4. **Beta-blockers**: Typically used for cardiovascular conditions, these may help in reducing cancer progression.
5. **Chloroquine and Hydroxychloroquine**: Used against malaria, they have shown potential in modulating the tumor environment and improving the effectiveness of chemotherapy.
It’s important to note that while these drugs show promise, they are still under investigation, and their use in treating IDC should be guided by oncologists based on clinical trials and evidence. - Metabolites
-
Invasive ductal carcinoma (IDC) is a type of breast cancer that begins in the milk ducts and invades surrounding tissues. Metabolites linked to IDC can vary, but common ones studied include:
1. Choline: Elevated levels are often associated with malignancies, including IDC.
2. Lactate: Increased levels can indicate anaerobic metabolism in tumor cells, a common characteristic of cancer.
3. Glycine: Often elevated in various cancers, including IDC, related to cell proliferation.
4. Glutamate: Increased levels can reflect cancer cell metabolism and growth.
These metabolites are often analyzed using techniques like magnetic resonance spectroscopy (MRS) or mass spectrometry to aid in the diagnosis and understanding of IDC. - Nutraceuticals
- There is no well-established evidence to support that nutraceuticals (foods or food products with health benefits) can effectively treat invasive ductal carcinoma (IDC), a common type of breast cancer. Patients should primarily follow conventional treatments such as surgery, radiation, chemotherapy, and hormonal therapy. Always consult with healthcare professionals before using any nutraceuticals or supplements, as they may interact with standard cancer treatments.
- Peptides
-
Invasive ductal carcinoma (IDC) is a type of breast cancer that begins in the milk ducts and then invades nearby tissue. There is ongoing research into the use of peptides and nanotechnology for its treatment and diagnosis.
Peptides can serve as therapeutic agents or be involved in targeted drug delivery systems, enhancing the ability to attack cancer cells while minimizing harm to healthy tissue. Nanotechnology can be utilized for similar purposes, offering advanced drug delivery systems, improved imaging techniques, and potentially more effective treatments by targeting cancer cells at the molecular level. Both fields hold promise for advancing IDC treatments.