Localized Treatment for Invasive Ductal Carcinoma

Obie Editorial Team

Once invasive ductal carcinoma (IDC) has been diagnosed and the stage, grade, and hormone receptor status have been identified, your doctor can then put together a comprehensive treatment plan to eliminate the cancer and, hopefully, prevent it from returning. Treatment falls into two broad scale categories: localized treatments and systemic treatments

Localized treatments include surgery and radiation. The size of the tumor dictates where in the treatment plan surgeries will occur and what type of surgery is appropriate. If the tumor is small, surgery can occur first; however, if the tumor has spread to the lymph nodes or other areas in the body, or if the tumor is large in size, other treatments might be required before the situation is optimal for surgery to be successful. These treatments can include chemotherapy or hormonal therapy. Some patients are able to just have one surgery, while others will require a series of surgeries for the desired aesthetic outcome. Personally, I had a total of six surgeries from beginning to end over a period of almost 2 years. The first five, however, were done in a span of 15 months. 

For very small tumors, a breast conserving lumpectomy may be possible. In this procedure, only the tumor and a margin of tissue around the tumor are removed. This procedure usually leaves only a small to medium scar. In some cases, the surgeon may want to remove some of the nearby lymph nodes. 

For larger tumors, a mastectomy is a more effective solution. There are three degrees of mastectomies: segmental or partial mastectomy, simple or total mastectomy, and modified radical mastectomy. Total radical mastectomies are rarely done today because other surgical procedures are just as effective and the trauma and recovery time for the patient are reduced. In the cases where a true radical mastectomy is necessary, the entire breast, some or all of the nearby axillary lymph nodes, and all of the chest wall muscle beneath the breast are all removed.

In segmental or partial mastectomies, which are also sometimes referred to a quadrantectomy, the area of the breast containing the tumor is removed, and some axillary lymph nodes may also be removed. It is possible for up to 25% of the breast to need to be removed.

In simple or total mastectomies, the entire breast is removed, but all muscle tissue and lymph nodes remain. Depending on the type of breast cancer and insurance, some patients may opt for a bilateral, or double, mastectomy to remove both breasts, even if the second breast does not currently contain a cancerous mass.

In modified radical mastectomies, an extensive surgery is done to remove the total breast, some of the nearby axillary lymph nodes, and the chest wall muscle lining. 

For patients who have a total or total bilateral mastectomy, breast reconstruction may be desired to restore the aesthetic appearance of the breasts. For more information on reconstructive procedures, check out Breast Cancer and Breast Reconstruction Surgeries, Breast Cancer and Breast Implant Reconstruction, Breast Cancer and TRAM Flap Breast Reconstruction Surgery, and Latissimus Dorsi (LD), Deep Inferior Epigastric Artery Perforator (DIEP), Transverse Upper Gracilis (TUG), and Gluteal Free Flap

For more information on Invasive Ductal Carcinomas, check out Signs and Symptoms of Invasive Ductal Carcinoma, Invasive Ductal Carcinoma – Diagnosis, Invasive Ductal Carcinoma – Staging and Grading, and Hormone Receptor Status of Invasive Ductal Carcinoma.