When we hear the word "breast cancer," everyone gets a little scared, right? That's very normal. But the most important thing is to be fully aware of this. Because then we can quickly recognize the symptoms and get the necessary medical advice. Today, we will talk about two very common types of breast cancer , Ductal Carcinoma. We will talk about this simply, in a way that you can understand.
Simply put, Ductal Carcinoma is a type of cancer that starts in the milk ducts of the breast. Did you know that there are two main types of this as well?
1. Invasive Ductal Carcinoma (IDC): In this, cancer cells break through the walls of the milk duct and spread to surrounding tissue.
2. Ductal Carcinoma in Situ (DCIS): In this, the cancer cells are inside the milk duct and have not yet spread outside.
The symptoms, diagnosis, and treatment of these two types are different. Let's first talk about the most common type, IDC.
What is Invasive Ductal Carcinoma (IDC)?
Invasive Ductal Carcinoma (IDC) is a very common type of breast cancer, accounting for about 80% of all breast cancers. It starts in the cells of a milk duct. But it doesn't stop there. The cells grow, break through the walls of the duct, and start to spread to the healthy tissue around the breast. Over time, these cancer cells can spread to other parts of the body.
What are the risk factors for developing IDC?
It's really hard to pinpoint the exact cause of all breast cancer. However, we do know some risk factors. Some of these are related to our lifestyle, some to hormones and family history .
The important thing is that having one or more of these risk factors does not mean you will develop cancer. And someone who does not have any of these factors can also develop cancer. It is important to be aware of these so that we can be aware of the changes we can make in our lifestyle.
Below are some of the common risk factors identified for IDC and other breast cancers.
| Risk factor | A simple explanation |
|---|---|
| Genetic variations that are passed down through generations | Gene mutations like BRCA1 and BRCA2 are inherited from the family. |
| Family history | Having a close relative, such as a mother or sister, with breast cancer. |
| Age | The risk increases after the age of 55. |
| Hormonal effects | Puberty before age 12, menopause after age 55, childlessness or having your first child after age 30, taking hormonal birth control methods and hormone therapy for menopause. |
| Lifestyle | Alcohol consumption, obesity, lack of physical exercise, and smoking. |
| Other factors | Having had radiation therapy to the chest at a young age, increasing the density of breast tissue. |
What are the symptoms of IDC?
A person with IDC may experience one or more of these symptoms. Not every time you have these symptoms, it's cancer, but if you see something like this, it's important to see your doctor right away for a checkup.
- A lump in the breast: a lump that feels like a lump in the hand.
- Skin thickening: A feeling as if part of the skin on the breast has thickened.
- Redness or rash : Redness of the skin of the breast.
- Swelling: Swelling that accompanies a change in the shape or size of the breast.
- Pain: New pain in the breast that was not present before.
- Skin sagging: A condition in which the pores of the skin of the breast become enlarged and sunken, resembling the skin of an orange (peau d'orange).
- Changes in the breast milk duct: the duct sinks in, becomes painful, or leaks a fluid other than milk (especially blood-colored).
- Armpit lumps: Lumps in the armpit area that are felt by the hand.
- Changes not related to the monthly menstrual cycle: Abnormal changes that are different from the normal changes that occur before menstruation.
How is IDC diagnosed? (Diagnosis)
IDC is usually first suspected when an abnormality is seen on a mammogram. Sometimes, a doctor may find a lump during a physical exam.
1. Mammogram and Ultrasound: These are the most basic tests. A mammogram takes an X-ray picture of the breast. An ultrasound uses sound waves to get a good picture of the tissue inside the breast and any lumps.
2. Biopsy: This is the test that 100% confirms whether it is cancer or not. Here, a very small piece of tissue is taken from the suspicious lump with the help of a needle and examined under a microscope. Only after this test can we know for sure whether there are cancer cells or not.
If the biopsy report confirms that it is cancer, the doctor will order several more tests. This is to find out exactly how big the cancer is and whether it has spread. Tests such as `CT scan`, `PET scan`, `MRI` may be used for this.
What are the treatment options?
There are several treatment options for IDC. Your doctor and your medical team will determine the best treatment plan for you. This will take into account many factors, including the stage of the cancer, its size, and whether it is hormone receptor-positive.
The main treatment methods are:
- Surgery:
- Lumpectomy: This involves removing only the cancerous tumor and a small amount of healthy tissue around it.
- Mastectomy: This is the surgical removal of the entire breast.
- Radiation Therapy: High-energy rays are used to destroy any cancer cells that may remain after surgery.
- Chemotherapy: These are powerful drugs given to kill cancer cells that have spread throughout the body. They are given to shrink the tumor before surgery or to kill any remaining cells afterward.
- Hormone Therapy: If the cancer is hormone-sensitive (HR+), drugs that block the action of hormones such as estrogen are given.
- Targeted Therapy: These drugs act on specific targets that affect the growth of cancer cells.
- Immunotherapy: Stimulates the body's own immune system to help identify and destroy cancer cells.
You may be prescribed one or a combination of these treatments. These treatments can cause some side effects. But there are now ways to control many of them. So don't be afraid to talk about it openly with your doctor.
Now let's look at Ductal Carcinoma in Situ (DCIS)
DCIS, as we mentioned earlier, is a non-invasive cancer that has not spread outside the milk ducts. This is the earliest stage of cancer, or stage 0 cancer.
Although DCIS is not aggressive, if left untreated, there is a risk that it will develop into an aggressive cancer like IDC in the future. This is why it is important to treat DCIS as soon as it is diagnosed.
Symptoms and treatment of DCIS
Most people with DCIS do not have any symptoms. It is usually diagnosed through a mammogram. Sometimes, symptoms such as a lump in the breast or bloody discharge from the nipple may be seen.
The main treatment for DCIS is surgery.
- Lumpectomy (removal of only the tumor) is often performed followed by radiation therapy .
- In some special cases (e.g. if DCIS has spread throughout the breast), a mastectomy (removal of the entire breast) may be necessary.
Chemotherapy is usually not necessary in cases of DCIS.
What can we do to reduce the risk of cancer?
We cannot change some risk factors, such as heredity. However, changing our lifestyle can reduce the risk of breast cancer to some extent.
- Limit alcohol: It is best to avoid drinking alcohol.
- Maintain a healthy weight: Obesity is a risk.
- Be active: Engage in exercise such as walking or running for at least 150 minutes a week.
- Avoid smoking.
- Eat a balanced diet: Adopt a diet rich in vegetables and fruits.
- Breastfeed your children: Breastfeeding has been found to reduce the risk of breast cancer.
- Follow your doctor's advice: Talk to your doctor about your family's cancer history. Get regular screenings like mammograms.
Take-Home Message
- IDC (Invasive Ductal Carcinoma) is a common type of breast cancer that starts in the milk ducts and spreads to surrounding tissue.
- DCIS (Ductal Carcinoma in Situ) is an early stage cancer that has not spread outside the milk ducts.
- Both of these are treatable conditions. The important thing is to diagnose them early and get proper treatment.
- If you notice any unusual changes in your breasts (a lump, pain, skin change), do not panic or delay and see your doctor immediately.
- The risk can be reduced by living a healthy lifestyle and undergoing regular medical checkups.
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