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Cancer In The Breast Duct

What Should A Person With Stage 0 Or Stage 1 Breast Cancer Expect Regarding Treatment

Surgeon simply explains breast ductal carcinoma in-situ (DCIS).

Even though Stage 0 breast cancer is considered non-invasive, it does require treatment, typically surgery or radiation, or a combination of the two. Chemotherapy is usually not part of the treatment regimen for earlier stages of cancer.

Stage 1 is highly treatable, however, it does require treatment, typically surgery and often radiation, or a combination of the two. Additionally, you may consider hormone therapy, depending on the type of cancer cells found and your additional risk factors. Like stage 0, Chemotherapy is often not necessary for earlier stages of cancer.

Material on this page courtesy of National Cancer Institute

What Questions Should I Ask My Healthcare Provider About Invasive Ductal Carcinoma

Fully understanding your situation can empower you and help you take control of your health. Here are some questions you might want to ask your healthcare provider:

  • What stage of invasive ductal carcinoma do I have?
  • How far has my cancer spread?
  • What are my treatment options?
  • How long will my treatment take?
  • Will I be able to work during my treatment?
  • What are my chances of survival?

How Is Invasive Ductal Carcinoma Diagnosed

Several tests can help your doctor identify and diagnose IDC, including:

Physical exam. Manual examination of your breasts by your doctor can detect lumps and other changes. If your doctor feels a lump or thickening, he or she may recommend further tests to rule out IDC.

Digital mammography is an improved method for breast imaging that is performed much like a regular mammogram. However, it is better than conventional mammography in detecting cancer in younger patients and in those with dense breast tissue. Electronic images can be enhanced with computer-aided detection systems to spot masses, calcifications and abnormalities associated with cancer.

Breast ultrasound uses sound waves to examine the breast tissue and gauge blood flow. It is safe for examining pregnant patients, and does not use radiation.

Breast magnetic resonance imaging uses a large magnet, radio waves and a computer that can detect small breast lesions, and may be especially useful in examining patients with a high risk of breast cancer, such as those with BRCA1, BRCA2 or other gene mutations associated with cancer.

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Diagnosing Invasive Ductal Carcinoma

Some women may feel a lump in their breast and seek evaluation, while others may learn they have breast cancer during their mammogram screening or breast X-ray. Other imaging tests and a biopsy may also be ordered to help the doctor assess the patients condition.

During a biopsy, the doctor removes some tissue or fluid from the breast for analysis under a microscope. The sample is sent off to a lab, where a pathologist checks for the presence of cancer cells, and it may take a few days to get the results.

If the diagnosis is breast cancer, the doctor then needs to determine its stage, including whether or not its started to spread inside or outside the breast. The specifics guide any treatment decisions.

Symptoms Of Invasive Ductal Carcinoma

Progression of Invasive Ductal Cancer

While there are some signs and symptoms of IDC to look out for, its important to remember that, like with any breast cancer, some women particularly those in the early stages may not notice any symptoms at all. The cancer may be first discovered on a routinemammogram before any symptoms are noticed, making regular check-ups all the more essential. However, there are some potential signs of IDC to look out for, including:

  • changes in the breast shape
  • breast or nipple pain
  • thickening of the nipple skin

If you notice any unusual changes in your breasts, its important to see a doctor as soon as you can.

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Breast Intraductal Papilloma Symptoms

A papilloma can present as a small outwardly curvedbump. Papillomas can either grow on the surface of the breast or within the breast ducts themselves. In the latter case, papillomas are only visible on mammography or by a microscope.

A papilloma will generally form right around or below the nipple. A woman may discover a small lump herself by doing breast self-exams or often a health care provider may find a small lump just beneath the surface through delicate palpation .

Papillomas can also be painful.

Imaging And Diagnostic Features Of Breast Papilloma

Mammograms and ultrasounds are not necessarily that useful in diagnosing an inverted papilloma.

A mammogram will generally be performed regardless as a precaution for any lesion involving bloody discharges, but intraductal papillomas do not tend to show up well on a mammogram.

Papillomas tend to be small and unless doctors suspect a large fat element, or a somewhat larger lump, the breast mammogram will probably look normal.

Ultrasound also does not reliably diagnose a papilloma. Ultrasound is generally useful in getting a reading on the relative amounts of fluid, solid, and fat elements in a lesion, and can readily determine if a lesion is a benign cyst .

Papillomas are generally non-liquid but do occasionally appear as solid nodules within a fluid-filled duct and some papillomas may present with cystic elements.

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How Is Dcis Diagnosed

DCIS doesnt usually appear as a breast lump or breast change. As a result, most women with DCIS do not show any signs or symptoms of having breast cancer.

Mammograms and ultrasounds are the most common ways in which DCIS is diagnosed. If DCIS is suspected, a biopsy is usually required to confirm whether DCIS is present.

Pathologists usually attribute a grade to DCIS. The grade indicates the patterns of cancer cell growth and how fast the cells are growing. Based on what the DCIS cancer cells look like under a microscope, DCIS can be graded as high, intermediate or low.

If left untreated, high grade DCIS is likely to develop into invasive breast cancer. Low or intermediate grades of DCIS may remain as they are for many years. In some cases, however, low or intermediate grades of DCIS can develop into invasive breast cancer.

While the size and grade of DCIS can help doctors predict whether the cancer is likely to become invasive, there are no certain answers. Unfortunately it is not currently possible to know for certain if a woman will go on to develop invasive breast cancer.

What Are The Symptoms And Signs Of Breast Cancer

Breast cancer video: explaining ductal carcinoma in situ

The most common symptoms of breast cancer include:

  • Feeling a lump in the breast area, with or without pain
  • Change in breast shape or size
  • Dimple or puckering in breast
  • A nipple turning inward into the breast
  • Nipple discharge other than breast milk, especially if it is bloody
  • Scaly, red, darkened or swollen skin in the breast area
  • Itchy, scaly sore or rash on the nipple
  • Dimple, pitted appearance or feel in the breast area
  • Swollen or enlarged lymph nodes around the breast area, including the collarbone and armpits

Although these symptoms can be caused by other conditions, you should check with a doctor preferably a breast health specialist so they can make a definitive diagnosis.

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Kinds Of Breast Cancer

The most common kinds of breast cancer are

  • Invasive ductal carcinoma. The cancer cells begin in the ducts and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
  • Invasive lobular carcinoma. Cancer cells begin in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

What Is Inflammatory Breast Cancer

Inflammatory breast cancer is a rare and very aggressive disease in which cancer cells block lymph vessels in the skin of the breast. This type of breast cancer is called inflammatory because the breast often looks swollen and red, or inflamed.

Inflammatory breast cancer is rare, accounting for 1 to 5 percent of all breast cancers diagnosed in the United States. Most inflammatory breast cancers are invasive ductal carcinomas, which means they developed from cells that line the milk ducts of the breast and then spread beyond the ducts.

Inflammatory breast cancer progresses rapidly, often in a matter of weeks or months. At diagnosis, inflammatory breast cancer is either stage III or IV disease, depending on whether cancer cells have spread only to nearby lymph nodes or to other tissues as well.

Additional features of inflammatory breast cancer include the following:

  • Compared with other types of breast cancer, inflammatory breast cancer tends to be diagnosed at younger ages.
  • Inflammatory breast cancer is more common and diagnosed at younger ages in African American women than in white women.
  • Inflammatory breast tumors are frequently hormone receptor negative, which means they cannot be treated with hormone therapies, such as tamoxifen, that interfere with the growth of cancer cells fueled by estrogen.
  • Inflammatory breast cancer is more common in obese women than in women of normal weight.

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Surgery To Remove Lymph Nodes

Most women with invasive breast cancer have surgery to remove some of the lymph glands from their axilla . We know that if invasive cancer spreads, it is likely to spread to the lymph glands first, so these are removed for testing.

In DCIS, the cancer cells are contained in the milk ducts and do not invade into the breast tissue and spread to the lymph glands. It is therefore not usually necessary to remove the glands. However, if there is a large area of DCIS or lots of small clusters of DCIS, the chances of finding invasive cancer in the DCIS is higher and your surgeon may recommend sentinel node biopsy of the lymph glands. When mastectomy is recommended for DCIS, a sentinel node biopsy is frequently recommended.

How Common Is Ductal Carcinoma In Situ

Ductal cancer stock vector. Illustration of cance, glands

DCIS is a common form of breast cancer among women and people assigned female at birth , accounting for 20% to 25% of all new cancer diagnoses annually. Men and people assigned male at birth can get DCIS, but its rare .

Cases of DCIS seem to have increased overall as more people have chosen to get yearly mammograms to screen for breast cancer. Also, mammography technology has improved to detect DCIS better. Increases in breast cancer diagnoses may sound like a negative, but its good news. Increased cases mean more people are getting diagnosed and treated early.

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What Are The Symptoms Of Inflammatory Breast Cancer

Symptoms of inflammatory breast cancer include swelling and redness that affect a third or more of the breast. The skin of the breast may also appear pink, reddish purple, or bruised. In addition, the skin may have ridges or appear pitted, like the skin of an orange . These symptoms are caused by the buildup of fluid in the skin of the breast. This fluid buildup occurs because cancer cells have blocked lymph vessels in the skin, preventing the normal flow of lymph through the tissue. Sometimes the breast may contain a solid tumor that can be felt during a physical exam, but more often a tumor cannot be felt.

Other symptoms of inflammatory breast cancer include a rapid increase in breast size sensations of heaviness, burning, or tenderness in the breast or a nipple that is inverted . Swollen lymph nodes may also be present under the arm, near the collarbone, or both.

It is important to note that these symptoms may also be signs of other diseases or conditions, such as an infection, injury, or another type of breast cancer that is locally advanced. For this reason, women with inflammatory breast cancer often have a delayed diagnosis of their disease.

Reducing Your Risk For Invasive Ductal Carcinoma

Anyone wanting to lower their risk for developing breast cancer should consider:

  • Exercising regularly
  • Losing weight if theyre overweight or obese
  • Speaking with their doctor about breast cancer risk when deciding on birth control pills or hormone replacement therapy
  • Cutting back on alcohol

When discussing breast cancer risk with a doctor, patients may want to ask for a personalized prevention strategy that includes screening guidelines.

Breast cancer treatment: The care you need is one call away

Your multidisciplinary team will work with you to develop a personalized plan to treat your breast cancer in a way that fits your individual needs and goals.

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How Can I Reduce My Risk For Invasive Ductal Carcinoma

Like most cancers, knowing your family history can help you take preventative steps, such as early screenings and mammograms. Even though invasive ductal carcinoma cant be prevented altogether, there are steps you can take to lower your risk:

  • Maintain a healthy body weight.
  • Dont smoke.
  • Eat a healthy, well-balanced diet.
  • Undergo genetic testing for gene mutations if recommended based on family history.

How Is Duct Ectasia Diagnosed

Common Types of Breast Cancer – Mayo Clinic

After a breast examination your GP is likely to refer you to a breast clinic, where youll be seen by specialist doctors or nurses.

At the breast clinic most people will have a breast examination followed by one or more of the following tests:

  • a mammogram
  • an ultrasound scan
  • a fine needle aspiration
  • a core biopsy

If you have nipple discharge thats bloodstained, this may also be tested.

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Dcis And Invasive Breast Cancer

If DCIS is not treated, over time it may spread into the breast tissue surrounding the ducts. It then becomes an invasive breast cancer.

Not every untreated DCIS will develop into an invasive breast cancer. But breast specialists usually advise treating DCIS. This is because it is not possible to tell for certain which individual cases of DCIS will become an invasive cancer.

Having DCIS means you have a slightly higher risk of getting cancer elsewhere in the same breast or in your other breast.

See also

How To Reduce Risk

There is no guaranteed way to prevent breast cancer, but there are certain steps a person can take to lower their risk.

Actions that may lower the risk of breast cancer include:

  • Get to a healthy weight: High body weight and weight gain as an adult increase the risk of breast cancer after menopause. The

Several benign breast conditions can cause symptoms that resemble those of cancer. Some of these issues require treatment, while others go away on their own.

Though these conditions are benign, they can cause:

  • discomfort or pain
  • lumps

Some common benign breast conditions include:

If a person is unsure what is causing any breast-related symptom, they should talk with a doctor as soon as possible.

As with most cancers, early breast cancer detection and treatment leads to a better outcome. People should attend regular breast examinations and tell a doctor about any breast-related symptoms or changes.

According to the ACS , when a doctor diagnoses breast cancer before it has spread beyond the breast, the relative 5-year survival rate is 99%.

Relative survival rates can help people understand the likelihood of treatment being successful. A relative 5-year survival rate indicates the percentage of people living 5 years after their diagnosis compared to people without the disease.

When breast cancer has spread beyond the breast to the lymph nodes, the 5-year survival rate is 86%. The same survival rate for cancer that has spread to other organs is 29%.

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What Does It Mean To Have Stage 1 Breast Cancer

In Stage 1 breast cancer, cancer is evident, but it is contained to only the area where the first abnormal cells began to develop. The breast cancer has been detected in the early stages and can be very effectively treated.

Stage 1 can be divided into Stage 1A and Stage 1B. The difference is determined by the size of the tumor and the lymph nodes with evidence of cancer.

What Clinical Trials Are Available For Women With Inflammatory Breast Cancer

Invasive ductal carcinoma of the breast

NCI sponsors clinical trials of new treatments for all types of cancer, as well as trials that test better ways to use existing treatments. Participation in clinical trials is an option for many patients with inflammatory breast cancer, and all patients with this disease are encouraged to consider treatment in a clinical trial.

Descriptions of ongoing clinical trials for individuals with inflammatory breast cancer can be accessed by searching NCIs list of cancer clinical trials. NCIs list of cancer clinical trials includes all NCI-supported clinical trials that are taking place across the United States and Canada, including the NIH Clinical Center in Bethesda, MD. For information about how to search the list, see Help Finding NCI-Supported Clinical Trials.

People interested in taking part in a clinical trial should talk with their doctor. Information about clinical trials is available from NCIs Cancer Information Service at 18004CANCER and in the NCI booklet Taking Part in Cancer Treatment Research Studies. Additional information about clinical trials is available online.

Selected References
  • Anderson WF, Schairer C, Chen BE, Hance KW, Levine PH. Epidemiology of inflammatory breast cancer . Breast Diseases 2005 22:9-23.

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    What Can I Expect If I Have Invasive Ductal Carcinoma

    If youve been diagnosed with invasive ductal carcinoma, your healthcare provider will discuss your treatment options with you in detail. For best results, youll want to begin treatment as soon as possible.

    How curable is invasive ductal carcinoma?

    Invasive ductal carcinoma is quite curable, especially when detected and treated early.

    What is the survival rate for invasive ductal carcinoma?

    The five-year survival rate for localized invasive ductal carcinoma is high nearly 100% when treated early on. If the cancer has spread to other tissues in the region, the five-year survival rate is 86%. If the cancer has metastasized to distant areas of your body, the five-year survival rate is 28%.

    Keep in mind that survival rates cannot tell you how long you will live. These numbers are based on people who have undergone breast cancer treatment in the past. For more information about your specific case, talk to your healthcare provider.


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