Invasive ductal carcinoma, also known as invasive ductal breast cancer, is the most common type of breast cancer.
‘Ductal’ refers to the ducts of the breast (tubes that carry milk to the nipple). This type of cancer starts in the ducts.
‘Invasive’ means the cancer cells are no longer only in the ducts. They have spread outside the ducts to the surrounding breast tissue.
‘No special type’ or ‘not otherwise specified’
Invasive ductal breast cancer may also be called:
- invasive breast cancer of no special type (NST)
- breast cancer not otherwise specified (NOS)
This is because the cancer cells have no features that class them as a specific type of breast cancer when examined under the microscope.
Sometimes invasive ductal breast cancer is found mixed with other types of breast cancer.
Symptoms of invasive ductal breast cancer include:
- a lump or thickening of the breast tissue
- a change of skin texture such as puckering or dimpling of the skin
- a lump or swelling under the arm
- changes to the nipple
- a discharge from the nipple
- a change in the size or shape of the breast
- constant pain in the breast or armpit
- less commonly, a type of rash involving the nipple known as Paget’s disease of the breast
Routine breast screening can often pick up cancer before a woman notices any symptoms. Therefore, some women will be diagnosed with invasive ductal breast cancer after attending breast screening without having any of the symptoms above.
Invasive ductal breast cancer is diagnosed using a range of tests. These may include:
- a mammogram (breast x-ray)
- an ultrasound scan (using sound waves to produce an image)
- a core biopsy of the breast and sometimes lymph nodes (using a hollow needle to take a sample of tissue to be looked at under a microscope – several tissue samples may be taken at the same time)
- a fine needle aspiration (FNA) of the breast and sometimes lymph nodes (using a fine needle and syringe to take a sample of cells to be looked at under a microscope)
When there is a change to the skin or nipple a punch biopsy of the skin may be performed.
Surgery to remove the cancer is usually the first treatment for invasive ductal breast cancer.
The type of surgery recommended may be:
- breast-conserving surgery: removal of the cancer with a margin (border) of normal breast tissue around it, also called wide local excision or lumpectomy
- a mastectomy: removal of all the breast tissue including the nipple area
If you’re going to have a mastectomy, you’ll usually be offered breast reconstruction.
Your treatment team will want to check if any of the lymph nodes (glands) under the arm contain cancer cells. This, along with other information about your breast cancer, helps them decide whether you will benefit from any additional treatment after surgery.
You can find out more about surgery to the lymph nodes on our surgery page.
Adjuvant (additional) treatment
After surgery you may need further treatment. This is called adjuvant treatment and can include:
The aim of this treatment is to reduce the risk of breast cancer returning in the same breast or developing in the other breast, or spreading elsewhere in the body.
Which treatments are recommended will depend on your individual situation.
Some of these treatments are given before surgery. This is known as neo-adjuvant or primary treatment.
You will continue to be monitored after your hospital-based treatments (such as surgery, chemotherapy or radiotherapy) finish. This is known as follow-up.
Being diagnosed with breast cancer can make you feel lonely and isolated.
Many people find it helps to talk to someone who has been through the same experience as them. Breast Cancer Now’s Someone Like Me service can put you in touch with someone who has had a diagnosis of breast cancer, so you can talk through your worries and share experiences over the phone or by email. You can also visit our online Forum and join one of the ongoing discussions.
If you would like any further information and support about breast cancer or just want to talk things through, you can speak to one of our experts by calling our free Helpline on 0808 800 6000.