Ductal Carcinoma, or Invasive Ductal Carcinoma (IDC) as it is often called, is the type of cancer present in 80 percent of all breast cancer diagnosis. Ductal refers to the fact that the cancer originates in the milk ducts of the breast; carcinoma refers to the fact that the cancer began in the skin or tissue on the breast (in fact, carcinoma is the term used for any cancers that begin in skin or tissue that cover organs). Ductal carcinoma is often said to be invasive if the cancer cells have extended beyond the walls of the milk duct into the breast's tissue. Because ductal carcinomas refer to cancer of the breast, staging is the same as for all breast cancers.
Staging
Cancer is staged using the American Joint Committee on Cancer (AJCC) staging system. The system is based on three factors, the "T" factor (which relates to the size of the tumor), the "N" factor (which relates to the extent of lymph node involvement) and the "M" factor (which relates to whether the cancer has spread or metastasized). Because of the three factors, the staging system is also referred to as the TNM system. Ductal carcinoma ranges from between Stage I and Stage IV, with Stage IV referring to advanced metastatic disease.
Stage I
Stage I cancer is diagnosed when the cancer cells begin to invade normal tissue near the ducts in which the cancer originated. In stage 1 cancer, the tumor may be up to 2 cms. The "N" number is 0, which means there is no cancer present in any lymph nodes, and the "M" number is 0, which means there are no metastases.
Stage II
There are two separate stages for Stage II Ductal Carcinoma. The first, Stage II A, may be diagnosed under a number of different conditions. If there is no visible tumor, but there is a presence of cancer in lymph nodes under the arm, it is Stage IIA. A tumor 2 cms or less in length with lymph node involvement is also Stage IIA. Finally, a tumor between 2 and 5 cm with no lymph node involvement is also Stage IIA. There are no metastases present in any of these diagnoses. Stage IIB ductal carcinoma is diagnosed when the tumor has grown to between 2 and 5 cm and there is lymph node involvement in areas under the arm, or the tumor has extended beyond 5 cm, but there is no lymph node involvement. Again, there are no metastases.
Stage III
Stage III has an A, B and C stage. Stage IIIA occurs when there is a visible tumor in the ducts and cancer present in a clump of lymph nodes, or in lymph nodes attached to other structures. Stage IIIB occurs when the tumor has spread to the skin of the breast and/or the chest wall, and when cancer may also be present in clumps of lymph nodes, lymph nodes close to the breast bone, or lymph nodes attached to other structures. Stage IIIC occurs when the cancer has penetrated the breast skin or chest wall and there is involvement of lymph nodes adjacent to the collarbone or breast bone.
Stage IV
Stage IV cancer refers to cancer that began in the ducts of the breast and metastasized to other parts of the body distinct from the breast. Common sites of metastases include the lungs, liver and bones. Once the cancer has spread to other sites in the body, the size of the tumor and the extent of the lymph nodes is irrelevant. Stage IV ductal carcinoma is not curable.
Tags: lymph nodes, lymph node, lymph node involvement, node involvement, cancer present, factor which, factor which relates
