An Overview of Invasive Ductal Carcinoma

What is Invasive Ductal Carcinoma?

If you have received a cancer diagnosis of invasive ductal carcinoma, you may not understand what that means. You may, like any of us would be, be scared. As one of the most common types of breast cancer, invasive ductal carcinoma–IDC–accounts for about 80% of all breast cancers. Also called infiltrating ductal carcinoma, cancer infiltrates and invades the breast tissue after bursting free of the milk ducts. A carcinoma is a cancer that begins in organ-lining tissue or skin. Therefore, the name–invasive ductal carcinoma–is no more than a definition of the thing it names.

What Causes Invasive Ductal Carcinoma?

Cancer can form anywhere when cells in a given area start to multiply after a change of shape or makeup. They multiply rapidly and don’t die when they should. In this case, the cells are increasing inside the milk ducts. There are several risk factors that could contribute to these changes in the cells (though sometimes the changes happen in people who do not have these risk factors and others have the risk factors and never get IDC). Some of the factors are being female, smoking, alcohol intake, previous radiation therapy, poor nutrition, family history of breast cancers, or potentially having mutations to some genes. The most commonly known breast cancer genes are BRCA1 and BRCA2 gene, which have been linked to IDC in some cases.

Is Invasive Ductal Carcinoma Dangerous?

In the early stages, IDC can be difficult to notice, as it causes few symptoms, which can make it dangerous. However, if you are doing regular self-breast checks and screening mammograms, it is likely to be caught sooner rather than later. Some signs of breast cancer to keep an eye out for during your breast checks are breast pain, nipple pain, inverted nipple, swelling of the breast (all or just a part), dimpling, irritation, redness, scaliness, or thickening of the nipple/breast skin or breast tissue, a lump in the underarm, or discharge from the nipple that is not milk.

What are the stages of Invasive Ductal Carcinoma?

Like many cancers, invasive ductal carcinoma is broken down into five stages, and each stage is measured in terms of the size of the tumor, how the lymph nodes are affected, and metastasis–where the cancer has moved throughout the body. All of these points are considered and taken into account, along with genetics, surgical results, and other considerations to assist in giving the patient their prognosis. The first stage is called stage 0, or ductal carcinoma in situ (DCIS), then Stage I is at when the cancer is starting to leave the milk ducts, and stage IV is when the cancer has spread outside the breast or auxiliary lymph nodes. For IDC specifically, this means:

Stage 0 — The disease is primarily in the ducts, though it may have spread to the lobules of the breast but no further. It is considered noninvasive at this point.

In the early part of Stage I (Stage IA), the tumor is small but has become invasive, though it still has not reached the lymph nodes. The cancerous area is between .2 mm and 20 mm.

Stage II can vary from person to person. Early Stage II  (Stage IIA) can either have no tumor, but the cancer has spread to up to three lymph nodes under the arm, a 20 mm or small tumor AND have spread to the lymph nodes or have a tumor that is between 20-50 mm without any spread to the lymph nodes. Later Stage II (Stage IIB), either has a tumor between 20-50 mm and has spread to the under-the-arm lymph nodes, or it must be over 50 mm without spreading to the nodes.

Fittingly, there are three phases to Stage III. In the first (Stage IIIA), the cancer (any size) has spread to 4-9 lymph nodes–under the arm or mammary. However, it has not spread anywhere else. If this is not the case, it could be a cancerous area of over 50 mm that has spread to 1-3 axillary lymph nodes. For the second phase of Stage III (Stage IIIB), the cancer may have been diagnosed as Inflammatory Breast Cancer due to its spread to the chest wall, swelling, and ulceration of the breast. Sometimes it will have spread to 9 or more lymph nodes–again, mammary or axillary–but most likely nowhere else. In Stage IIIC, any tumor will have spread to 10 or more lymph nodes. These could be mammary lymph nodes, axillary lymph nodes, or the lymph nodes under the collarbone. However, the cancer still has not spread throughout the body.

Stage IV is also known as Metastatic cancer. Metastasis is when the cancer has spread to other parts of the body such as distant lymph nodes, bones, other organs, or the chest wall. The tumor can be any size. Cancer is first diagnosed as metastatic about 5-6% of the time and is most commonly found after previous diagnoses of early breast cancer.

Survival Rate of Invasive Ductal Carcinoma

As of 2017, the survival rates for people treated for breast cancers have been increasingly favorable. For those in stages zero and one, the survival rate–measured as the five-year survival rate–is nearly one hundred percent. For those with stage two breast cancer, the survival rate is 93 percent, an increase from the 86 percent survival rate of 2014. For stage three, the five-year survival rate is 72 percent, a dramatic increase from 2014’s 57 percent. Finally, stage four is currently holding at a 22 percent survival rate, a jump from 2014’s 20 percent.

Is Invasive Ductal Carcinoma Curable?

Just as every patient’s experience with cancer is unique, so is their treatment. There may be a form of drug therapy, such as chemotherapy, a hormone therapy, HER2 targeted drug, or some combination. There could be surgery such as a breast-conserving surgery (lumpectomies, partial mastectomies) or a mastectomy, which can involve breast reconstruction. The patient may need radiation therapy to prevent a recurrence of the cancer. Your treatment route is determined by many factors. Family history can come into play, as can the size of the cancer, the type of tumor, maybe genetics, and how far this invasive breast cancer has spread. However, just as important is you and where you stand in all the chaos. Make sure you understand what your treatments are. Ask your doctors questions. They are there to assist you through your process and make sure you are receiving the right treatment.

Dr. Valerie Gorman

Dr. Gorman and everyone with her at the Texas Breast Center are there to help you with your questions about invasive ductal carcinoma and its treatment. She will walk with you through the whole process, and she knows how important it is for you to be informed. She and her team will cater your treatment to your needs and walk with you on your journey through this process.


Mastitis and Inflammatory Breast Cancer: Things You Should Know

What is Mastitis?

Mastitis (commonly known as ‘Lactation or Puerperal Mastitis,’ terms related to post childbirth) is an infection that occurs in the breast tissue. This condition is often caused by tears around the nipple, obstructed milk ducts, or improperly drained milk; this is a common occurrence with breastfeeding mothers and new mothers who have had a baby within the last 6 to 12 months, but can also occur at other times in life. When cases of bacteria appear within the breast due to a tear or obstruction, the body combats the infection with white blood cells. This results in symptoms include swelling, pain, redness, a fever accompanied with chills, and warmth of skin in (typically) one breast. Rest assured, Lactating Mastitis is unrelated to breast cancer and will not increase your risk for breast cancer.

In the case of rare conditions such as Non-Lactational Mastitis, which is a occurs in women with diabetes, women with depressed immune systems, and women who have lumpectomies following radiation therapy. New symptoms similar to Lactation Mastitis and women experiencing Non-Lactational Mastitis should consult their medical professional to discuss their overall health and how to support their breast health better.

Are the symptoms of Mastitis and breast cancer similar?

Yes, in the case of Inflammatory Breast Cancer, often the symptoms present in a similar way as does Mastitis. It is crucial to see your doctor to examine the area to positively identify cases of Mastitis. If you are experiencing symptoms such as itching, a rash, an inward nipple, swelling, rapid increase in breast size, nipple discharge, discoloration of a breast that starts off pink progressively turns purple, and ridged, thick skin (comparable to an orange peel), you may have Inflammatory Breast Cancer (IBC). Due to the common symptoms caused by Mastitis and Inflammatory Breast Cancer, it is crucial to pay attention to the affected area and consult a medical professional. Inflammatory Breast Cancer does not show symptoms like the standard breast cancer disease because Inflammatory Breast Cancer does not cause a breast lump and may not show up in a mammogram, making it more difficult to diagnose the disease. Infection or injury to breasts do not cause breast cancer because breast cancer is caused by cancer cells blocking lymph vessels within the body. Although less common than non-inflammatory breast cancer, Inflammatory Breast Cancer is aggressive and needs immediate treatment. Generally, within 1-3 months symptoms appear and rapidly spread to nearby lymph nodes. Inflammatory Breast Cancer is often treatable. Patients who seek earlier treatment have higher success rates after Inflammatory Breast Cancer is diagnosed.

What Should I Do If I Have Mastitis?

If you have conditions of Mastitis, it is best to see your medical professional to begin early diagnosis and treatment. Anticipate tests such as a mammogram or biopsy of breast tissue to determine Mastitis or breast cancer. If tests results show Mastitis, antibiotics are administered to eliminate the infection from the breast tissue, and women usually feel relief in 48 to 72 hours. If there are complications, such as a breast abscess, expect to have the fluid drained from the breast either through surgery or a needle aspiration. Despite the ease of clearing Mastitis through prescribed antibiotics, ignoring symptoms can be serious as infection could affect the bloodstream.

Although it might be uncomfortable, it is okay to continue nursing while experiencing Mastitis. Mastitis will not affect the health of the baby or milk produced from breasts. To prevent Mastitis while breastfeeding, try to receive proper amounts of sleep and eating balanced meals to maintain a healthy body to fight infections. Make sure to breastfeed often as well emptying the breast of milk after nursing by using a breast pump, or by massaging breasts to remove any excess milk to keep the milk ducts open and free from obstructions. Note to also alternate breasts in which the baby latches onto for feeding, and support the baby to latch onto the nipple properly. Mastitis can occur when the mother suddenly stops breastfeeding the baby, as her breasts continue to produce milk causing the milk in the breasts to become stagnant and a hub for bacteria. Try weaning the baby off of breastfeeding over a period of time instead of suddenly stopping. This allows for the breasts to slow milk production. Another method of prevention is to take care of the nipple skin to avoid irritation or cracking by using a 100% pure lanolin ointment. This is safe for breastfeeding and is hypoallergenic.

What Should I Do If I Have Inflammatory Breast Cancer?

Dr. Gorman will review your diagnosis carefully and recommend treatment options. Often, treatment begins with chemotherapy. Breast surgery may then be needed to remove the breast (mastectomy), or part of the breast (lumpectomy) and to possibly remove lymph nodes that have been affected by Inflammatory Breast Cancer. Surgery can also support cosmetic enhancements to the breasts when the cancer is removed.

Dr. Gorman will then discuss whether radiation is needed, clearly communicating its risks and added benefits.

If you are concerned that you may have cancer and not mastitis, do not hesitate to contact us. We want you to be proactive in seeking answers. Valerie Gorman, MD is a breast surgeon who specializes in personalized treatments for breast cancer. Should you have breast cancer, you are in good hands at Texas Breast Center. Dr. Gorman will walk alongside the patient, from the first mammograms, through surgery and any additional treatments, to follow visits in the future, all for your peace of mind. Her efforts to ensure you have a caring medical professional at every stage of cancer treatment allows for patients and families feel assured that she genuinely cares about their recovery. Dr. Gorman always attempts to accelerate the process with her hands-on approach and clear communication, so there is not the anxious waiting that patients often experience at other breast cancer centers


How Can I Improve My Self-Image After Breast Cancer?

body image after breast cancer pinkBody image issues are real concerns for women cancer patients that can impact self-esteem and mental health. You may view your body and yourself differently after breast cancer. Give yourself time to adjust. It takes time to adapt, so remember to treat yourself with compassion and kindness. Talking with others who have been in similar situations either in one on one conversations or support groups may help. This can be instrumental in providing understanding and hope. Keep your network of family and friends close and let them give you comfort. It’s okay to ask for and accept help.

If you struggled with your body image before the cancer diagnosis, then you may have an even harder time coping with changes in your appearance after. The reaction of people close to you and others can affect the way a person adjusts to the changes, as well. Counseling can be helpful if body image is a significant issue for you, particularly if it negatively impacts your return to work and/or other normal activities before cancer.

Along with the emotional stress that cancer and its treatment can cause, it may also change how you look. Many women with breast cancer feel self-conscious about changes to their bodies. Some physical changes may only last a short time while others are permanent.

Possible Changes in Physical Appearance Due to Breast Cancer Include:

  • Scars from surgery (Scarring After Breast Cancer Surgery);
  • Hair loss as a result of chemotherapy or radiation therapy;
  • Surgical modification of body parts;
  • Weight gain/loss;
  • Skin changes such as redness, itching, more sensitivity, or pain in the area that was treated;
  • Loss of muscle mass or muscle weakness;
  • Lymphedema; and
  • Changes in sexual functioning.

Hair Loss and Breast Cancer

One of the possible changes listed above is hair loss from radiation therapy or chemotherapy treatments. Hair loss can be especially stressful. Ask Dr. Gorman about possible ways to retain your hair with the use of cooling caps or scalp cooling systems. If hair loss is going to happen, it most often starts within two weeks of treatment and gets worse one to two months after starting therapy. Your scalp may feel very sensitive to washing, combing, or brushing. It’s important to note that hair often begins to grow back even before treatment ends.

You’ve got choices even if you do lose all of your hair. There are many cover-ups to choose from, or you can go bald. However, many women want to find some way to conceal their bald head and keep warm. Then it’s a matter of what you’re most comfortable with whether it’s a wig, a scarf, or a hat. Be creative.

Lymphedema As Result of Cancer Treatment

Another physical change that you may not be familiar with is lymphedema, and it refers to swelling that generally occurs in one of your arms or legs and sometimes both. It’s most commonly caused by the removal of or damage to your lymph nodes as part of your cancer treatment. This happens because there is a blockage in your lymphatic system, which is part of your immune system. This blockage prevents lymph fluid from draining, and the fluid buildup leads to swelling.

Lymphedema Signs and Symptoms:

  • Swelling occurring in part or all of your arm or leg, including fingers and toes;
  • A feeling of heaviness or tightness;
  • Restricted range of motion;
  • Aching or discomfort;
  • Recurring infections; and
  • Hardening and thickening of the skin (fibrosis).

While there is presently no cure for lymphedema, it can be managed with early diagnosis and diligent care of your affected limb.

Changes in Your Sex Life Due to Breast Cancer

Talking about your sex life and relationships can be extremely uncomfortable especially after dealing with changes from your illness. You’re not sure exactly what’s wrong or how to treat it, but you know things are different. Many women report having less sex after their illness and here are a few reasons why:

  • A common issue that many women bring up is not feeling “sexy” anymore. This is so understandable because breast cancer is such a physically and emotionally taxing experience that changes so many aspects of a woman’s life.
  • Having breast cancer slows down your body and can result in taking longer to do lots of things, including getting interested in and starting and finishing sexual intercourse.
  • For the woman that has been thrown into sudden-onset menopause, sex can be not just uncomfortable, but even painful. So, not surprising that you may have less sex, for now. Many women report having had little or no sex from the time of diagnosis through treatment.

How breast cancer affects your sexuality is different for every woman. You may find the support you need from your healthcare team, partner, family, friends or other survivors. A support group or close friend may be the key to you reconnecting with your own sexuality. Many online groups host discussion boards where you can “talk” about concerns with someone who has been there.

Finding Help and Support During and After a Breast Cancer Diagnosis

Learning to be comfortable with your body and self-image during and after breast cancer treatment is different for every woman. The right information and support can help you manage these changes over time. It’s essential for you to know that regardless of your experience with breast cancer, there is advice and support to help you cope. Talking with Dr. Gorman and your healthcare team at Texas Breast Center is a great place to start.

Resources:

If you’re interested in visiting a Breast Cancer Support Group, contact Texas Breast Center for more information.


What To Say To Someone With Breast Cancer

what to say to someone with breast cancerWhen someone gets diagnosed with breast cancer, the world can seem a very lonely place; there is no right or wrong way to react, everyone is an individual and will cope with challenges differently. An issue that many patients have talked about is the reactions of their friends and family, once they do summon up the courage to break the news.

Very few partners, family members or friends are likely to be trained counselors, and even if they were, it is much more difficult saying the right thing to someone who means the world to you personally. Most people it seems, feel obligated to say something, and it is a fair assumption, that a pregnant pause or an extended period of silence is not what your friend or relative is looking for, but the question is what is the right thing to say in this situation? After all none of us are trained in these matters, and we all want to help, so let’s examine some potential ideas so that if you ever find yourself in this situation, you won’t be left speechless.

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What Is Invasive Lobular Breast Cancer?

what is invasive lobular breast cancerBreast Cancer consists of many different types, so if you have been diagnosed with Breast Cancer, then it is important that you understand which specific kind of Breast Cancer you have. The treatment, prognosis, and outlook vary depending on the different type.

Invasive Lobular Breast Cancer takes its name from the origin of this type of breast cancer. It begins and develops within the milk-producing glands of the breast. These are known as the lobules, which is where the name of this particular cancer originates. The Invasive part of the name differentiates between cancer and pre-cancer.

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