Invasive ductal carcinoma (IDC) treatment often involves surgery to remove the cancer. Other treatment options include radiation therapy, chemotherapy, estrogen blocker therapy, targeted therapy and immunotherapy. Most people have more than one treatment.
Invasive ductal carcinoma treatment is similar to treatment for other types of breast cancer. There are no treatments that are specific to invasive ductal carcinoma. Your treatment options depend more on the stage of your cancer, the hormone receptor status and the HER2 status.
Most people with stage 1 or stage 2 invasive ductal carcinoma will have surgery as the first treatment. Most also will have other treatments after surgery, such as radiation, chemotherapy or estrogen blocker therapy. These other treatments kill any cancer cells that might be left after surgery and lower the risk that the cancer will come back.
Sometimes treatment starts with medicines. Your care team might recommend this if you have a stage 3 invasive ductal carcinoma that has grown large or spread to the lymph nodes. Using medicine first may shrink the cancer so that surgery is possible or so that you might consider a less invasive surgery. It also gives your care team a chance to see how the cancer responds to medicines. The response tells the care team about your prognosis and helps them make decisions about the next steps.
For a stage 4 invasive ductal carcinoma that has spread to other parts of the body, treatment uses medicines. Surgery usually isn't used to remove the cancer in the breast if the cancer has spread.
There are many options for breast cancer treatment. You don't have to sort through them on your own. Your healthcare team can help explain your options and work with you to choose a treatment plan that fits your needs and goals. Consider seeking a second opinion from a breast specialist in a breast center or clinic. Some people also find it helpful to talk with breast cancer survivors who have faced similar decisions.
Breast cancer surgery
Breast cancer surgery typically involves a procedure to remove the breast cancer and, sometimes, a procedure to remove some nearby lymph nodes. The main surgical procedures used to treat invasive ductal carcinoma include:
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Lumpectomy. A lumpectomy is surgery to remove the breast cancer and some of the healthy tissue around it. It allows you to maintain most of your breast. Other names for this surgery are breast-conserving surgery and wide local excision. Most people have radiation therapy after lumpectomy.
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Mastectomy. A mastectomy is surgery to remove all breast tissue from a breast. Total mastectomy, also called simple mastectomy, removes all of the breast, including the lobules, ducts, fatty tissue and some skin, including the nipple and areola. Other procedures include skin-sparing mastectomy, which leaves the skin, and nipple-sparing mastectomy, which leaves the areola, nipple and skin.
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Lymph node surgery. Lymph node surgery removes nearby lymph nodes to check them for cancer. When breast cancer spreads it most often goes to the lymph nodes under the arm. A sentinel node biopsy removes some of those lymph nodes for testing. An axillary lymph node dissection removes most of the underarm lymph nodes.
For early-stage invasive ductal carcinoma, lumpectomy followed by radiation has the same survival rate as mastectomy. The type of cancer doesn't affect which procedure you should have. The decision depends more on your personal preferences and the details of your cancer. Lumpectomy is preferred for small cancers in people who are willing to have radiation. Lumpectomy is typically used when there is only one small area of cancer in the breast. Mastectomy is preferred for larger cancers or when there are multiple areas of cancer in the breast. Mastectomy might be used in those who don't want or can't have radiation.
You may choose to have breast reconstruction after mastectomy surgery. Breast reconstruction is surgery to restore the shape to the breast. Options might include reconstruction with a breast implant or reconstruction using your own tissue. Consider asking for a referral to a plastic surgeon before your breast cancer surgery.
Radiation therapy
Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources.
Radiation therapy for breast cancer often uses external beam radiation. During this type of radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.
Radiation therapy is often used after surgery for invasive ductal carcinoma. It can kill any cancer cells that might be left after surgery. The radiation lowers the risk of the cancer coming back.
Chemotherapy
Chemotherapy treats cancer with strong medicines. Many chemotherapy medicines exist. Chemotherapy for breast cancer often involves a combination of medicines. Most are given through a vein. Some are available in pill form.
Chemotherapy is often used after surgery to treat invasive ductal carcinoma. It can kill any cancer cells that might remain and lower the risk of the cancer coming back.
Sometimes chemotherapy is given before surgery. This may help shrink the cancer so that surgery is possible or so that you might consider a less invasive surgery. It also gives the care team a chance to see how the cancer responds to medicines.
When the cancer spreads to other parts of the body, chemotherapy can help control it. Chemotherapy may relieve symptoms of an advanced cancer, such as pain.
Estrogen blocker therapy
Estrogen blocker therapy treats breast cancer that is sensitive to hormones. This means the cancer cells have proteins called receptors. The receptors bind to the hormones estrogen and progesterone. The cancer grows in response to these hormones. Healthcare professionals call these cancers hormone receptor positive. Most breast cancers, including most invasive ductal carcinomas, are sensitive to hormones.
Estrogen blocker therapy also is called endocrine therapy and hormone therapy for breast cancer.
Estrogen blocker therapy treatments can include:
- Medicines that block or destroy hormone receptors. These medicines are called selective estrogen receptor modulators.
- Medicines that lower hormone production. These medicines are called aromatase inhibitors.
- Surgery or medicines to stop the ovaries from making hormones.
Estrogen blocker therapy often is used after surgery and other treatments. It can lower the risk that the cancer will come back.
If the cancer spreads to other parts of the body, estrogen blocker therapy can help control it.
Targeted therapy
Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.
Some treatments target cancer cells that make extra HER2. Breast cancer that makes extra HER2 is called HER2-positive breast cancer. Other targeted therapy medicines attack other proteins in the body that help cancer cells grow. Your cancer cells may be tested to see whether these medicines might help you.
Targeted therapy medicines may be used before surgery to shrink the cancer and make it easier to remove. They also may be used after surgery to lower the risk that the cancer will come back.
Some targeted therapy medicines are used only when the cancer has spread to other parts of the body.
Immunotherapy
Immunotherapy is a treatment with medicine that helps the body's immune system to kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells.
Immunotherapy might be an option for treating invasive ductal carcinoma that's triple negative. Triple-negative breast cancer means that the cancer cells don't have hormone receptors and don't make extra HER2. This treatment may be used before and after surgery.