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Invasive ductal carcinoma (IDC) is a kind of breast cancer. It causes a growth of cells in the tubes that can carry breast milk to the nipple. These tubes are called ducts.

Invasive ductal carcinoma is an invasive cancer, which means that the cancer cells have broken through the duct and grown into the surrounding breast tissue. The cells can spread to the lymph nodes and other parts of the body. This is different from ductal carcinoma in situ (DCIS). DCIS happens when cancer cells form inside a duct but haven't grown outside of it. DCIS is a noninvasive form of ductal carcinoma.

Invasive ductal carcinoma, also called infiltrating ductal carcinoma, is the most common type of breast cancer. Most breast cancers are invasive ductal carcinomas. The other main type of breast cancer is invasive lobular carcinoma. It forms in the milk-producing glands in the breast, called lobules.

Compared with the lobular type, invasive ductal carcinoma is more likely to cause a lump in the breast. It's also more likely to be detected on an imaging test, such as a mammogram.

There are many treatment options for invasive ductal carcinoma. Care is often tailored to your specific situation, and advances in treatment continue to expand those options. Many people who receive this diagnosis are cured. When a cure is not possible, treatments may help control the cancer and help you live longer.

Breast cancers, including invasive ductal carcinomas, are often grouped into subtypes based on the results of tests on the cancer cells. Lab tests can show whether the cells use hormones or a protein called human epidermal growth factor receptor 2 (HER2) to help them grow. Whether the cancer uses one, both or none of these determines the type.

Hormone receptor positive

Hormone receptor (HR) positive invasive ductal carcinomas use the hormones estrogen and progesterone to help them grow. If testing finds the cancer cells have proteins called receptors for one or both hormones, the cancer is HR positive. HR-positive cancers tend to grow slowly and respond well to estrogen blocker therapy.

HER2 positive

HER2-positive invasive ductal carcinoma makes extra HER2 protein and uses it to help fuel the cancer growth. Healthy breast cells make some HER2, but the cancer cells can make a lot more. If tests detect extra HER2 in the cancer cells or extra copies of the genes that make HER2, the cancer is HER2 positive.

HER2-positive breast cancers tend to grow quickly. But there are many treatments that can target HER2.

HER2 negative

HER2-negative invasive ductal carcinoma doesn't make extra HER2. These cancers don't respond to treatment with medicines that target HER2.

Breast cancers that make a low level of HER2 are sometimes called HER2 low or HER2 ultralow. These cancers don't make enough HER2 to be considered HER2 positive, but they may respond to treatment with medicines that target HER2.

Triple positive

Triple-positive invasive ductal carcinoma has hormone receptors and makes extra HER2. These cancers respond to treatment with estrogen blocker therapy and to medicines that target HER2. Both approaches are often used to treat these cancers.

Triple negative

Triple-negative invasive ductal carcinoma doesn't have hormone receptors and doesn't make extra HER2. These cancers tend to grow quickly and are often diagnosed at a later stage. They don't respond to treatment with estrogen blocker therapy or medicines that target HER2. Triple-negative breast cancers respond to chemotherapy and may benefit from treatment with immunotherapy.

Invasive ductal carcinoma (IDC) doesn't always cause symptoms at first. Like other types of breast cancer, it may be found on a screening test, such as a mammogram, before it ever causes symptoms.

When they happen, invasive ductal carcinoma symptoms may include:

• A breast lump or thickened area of skin that feels different from the surrounding tissue.
• A nipple that looks flattened or turns inward.
• Changes in the color of the breast skin. In people with white skin, the breast skin may look pink or red. In people with brown and Black skin, the breast skin may look darker than the other skin on the chest or it may look red, purple or brown.
• Change in the size, shape or appearance of a breast.
• Changes to the skin over the breast, such as skin that looks dimpled or looks like an orange peel.
• Peeling, scaling, crusting or flaking of the skin on the breast.

Compared with other types of breast cancer, invasive ductal carcinoma is more likely to form a lump in the breast tissue. The other main type of breast cancer, invasive lobular carcinoma, often doesn't cause a lump you can feel.

When to see a doctor

If you find a lump or other change in your breast, make an appointment with a doctor or other healthcare professional. Don't wait for your next mammogram. Report any changes in your breasts even if a recent mammogram showed there was no breast cancer.

The exact cause of invasive ductal carcinoma (IDC) isn't known. Research has found a link between invasive ductal carcinoma and a family history of breast cancer, obesity and drinking alcohol. But it's not clear why some people who have all these risk factors don't get cancer and some people without any risk factors do. It's likely that invasive ductal carcinoma is caused by a complex mix of your genetic makeup and the world around you.

Invasive ductal carcinoma starts when something changes the DNA inside cells within a milk duct. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to multiply at a set rate. The instructions also tell the cells to die off at a set time. In cancer cells, the changes to the DNA alter the instructions for multiplying and dying. The result is that the cancer cells multiply faster than healthy cells. And they can keep living when healthy cells would die. This causes too many cells in the area.

The cancer cells might form a growth, called a tumor, inside the milk duct. In invasive ductal carcinoma, the tumor grows beyond the duct and into the nearby breast tissue. The tumor can take over the local blood supply. Over time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer. Invasive ductal carcinoma most often spreads to the bones, lungs, liver and brain.

Risk factors for invasive ductal carcinoma are the same as the risk factors for breast cancer in general. Factors that may increase the risk of breast cancer include:

• A family history of breast cancer. If a parent, sibling or child had breast cancer, your risk of breast cancer is increased. The risk is higher if your family has a history of getting breast cancer at a young age. The risk also is higher if you have multiple family members with breast cancer. Still, most people diagnosed with breast cancer don't have a family history of the disease.
• A personal history of breast cancer. If you've had cancer in one breast, you have an increased risk of getting cancer in the other breast.
• A personal history of breast conditions. Certain breast conditions are markers for a higher risk of breast cancer. These conditions include lobular carcinoma in situ (LCIS) and atypical hyperplasia of the breast. If you've had a breast biopsy that found one of these conditions, you have an increased risk of breast cancer.
• Being female. Women are much more likely than men are to get breast cancer. However, everyone is born with some breast tissue, so anyone can get breast cancer, including men.
• Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
• Beginning menopause at an older age. Beginning menopause after age 55 increases the risk of breast cancer.
• Dense breast tissue. Breast tissue is made up of fatty tissue and dense tissue. Fatty tissue is made of fat. Dense tissue is made of milk glands, milk ducts and fibrous tissue. If you have dense breasts, you have more dense tissue than fatty tissue in your breasts. Having dense breasts increases the risk of developing breast cancer and makes it harder to detect cancer on a mammogram. Talk with your healthcare team about other tests you might have in addition to mammograms to look for breast cancer.
• Drinking alcohol. Drinking alcohol increases the risk of breast cancer. There is no safe amount of alcohol when it comes to breast cancer. The more alcohol you drink, the greater your risk.
• Having never been pregnant. Having been pregnant one or more times lowers the risk of breast cancer. Never having been pregnant increases the risk.
• Having your first child at an older age. Giving birth to your first child after age 30 may increase the risk of breast cancer.
• Increasing age. The risk of breast cancer goes up as you get older.
• Inherited DNA changes that increase cancer risk. Certain DNA changes that increase the risk of breast cancer can be passed from parents to children. The most common changes are in genes called BRCA1 and BRCA2. These changes can greatly increase your risk of breast cancer and other cancers, but not everyone with these DNA changes gets cancer.
• Menopausal hormone therapy. Taking certain hormone therapy medicines to manage the symptoms of menopause may increase the risk of breast cancer. The risk is linked to hormone therapy medicines that combine estrogen and progesterone.
• Obesity. Obesity increases the risk of breast cancer.
• Radiation exposure. Radiation treatments to the chest as a child or young adult raises the risk of breast cancer.

You can take steps to help lower your risk of invasive ductal carcinoma (IDC) and other types of breast cancer.

Ask about breast cancer screening

Talk with your doctor or other healthcare professional about when to begin breast cancer screening. Ask about the benefits and risks of screening. Together, you can decide what breast cancer screening tests are right for you.

Become familiar with your breasts

Do occasional breast self-exams so that you know what your breasts typically feel like. If there is a new change, a lump or something not typical in your breasts, report it to a healthcare professional right away.

Breast awareness through self-exams can't prevent breast cancer. But it may help you to better understand the look and feel of your breasts. This might make it more likely that you'll notice if something changes.

Drink alcohol in moderation, if at all

If you choose to drink alcohol, limit how often you drink and keep the amount small. For overall health, drink one or fewer drinks a day. Do not drink every day. The less you drink, the better.

For breast cancer prevention, there is no safe amount of alcohol. So if you're concerned about your breast cancer risk, you may choose to not drink alcohol.

Exercise most days of the week

Aim for at least 30 minutes of exercise on most days of the week. If you haven't been active lately, ask a healthcare professional whether it's OK and start slowly.

Limit menopausal hormone therapy

Hormone therapy that uses a combination of estrogen and progesterone may increase the risk of breast cancer. Talk with a healthcare professional about the benefits and risks of hormone therapy.

Maintain a healthy weight

If your weight is healthy, work to maintain that weight. If you need to lose weight, ask a healthcare professional about healthy ways to lower your weight. In general, try to eat fewer calories and slowly increase how much you exercise.

Talk with a healthcare professional about your cancer risk

If you have a family history of breast cancer or think that you may have an increased risk of breast cancer, talk about it with your healthcare professional. Preventive medicines, surgery and more-frequent screening may be options for people with a high risk of breast cancer.

A diagnosis of invasive ductal carcinoma (IDC) may begin with an exam and a discussion of your symptoms. Sometimes the diagnosis starts when an imaging test, such as a mammogram, finds something concerning in a breast. To confirm whether there is cancer or not, your healthcare professional may recommend a procedure called a biopsy to remove breast tissue for testing. While many tests can spot something in the breast that may be cancer, a biopsy is the only test that can say whether you have invasive ductal carcinoma.

Breast exam

During a breast exam, a healthcare professional looks at the breasts for anything that's not typical. This might include changes in the skin or to the nipple. Then the health professional feels the breasts for lumps. The health professional also feels along the collarbones and around the armpits for lumps.

Mammogram

A mammogram is an X-ray of the breast tissue. Mammograms are commonly used to screen for breast cancer. If a screening mammogram finds something concerning, you might have another mammogram to look at the area more closely. This more-detailed mammogram is called a diagnostic mammogram. It's often used to look closely at both breasts.

On a mammogram, invasive ductal carcinoma typically looks like a growth with irregular borders.

Breast ultrasound

Ultrasound uses sound waves to make pictures of structures inside the body. A breast ultrasound may give your healthcare team more information about a breast lump. For example, an ultrasound might show whether the lump is a solid mass or a fluid-filled cyst. The healthcare team uses this information to decide what tests you might need next.

On a breast ultrasound, invasive ductal carcinoma typically looks like a dark spot with an irregular border. The ultrasound may show thin lines extending from the edge of the cancer.

Breast MRI

MRI machines use a magnetic field and radio waves to create pictures of the inside of the body. A breast MRI can make more-detailed pictures of the breast. Sometimes this method is used to look closely for any other areas of cancer in the affected breast. It also might be used to look for cancer in the other breast. Before a breast MRI, you usually receive an injection of contrast material. The contrast helps the tissue show up better in the images.

Breast biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. For a breast biopsy, a healthcare professional puts a needle through the skin and into the breast tissue. The health professional guides the needle using images created with X-rays, ultrasound or another type of imaging. Once the needle reaches the right place, the health professional uses the needle to draw out tissue from the breast. A marker may be placed in the spot where the tissue sample was removed. This small metal marker shows up on imaging tests. It helps your healthcare team mark the area of concern.

Lab testing

The tissue sample from a biopsy goes to a lab for testing. Tests can show whether the cells in the sample are cancerous. Other tests give more details about the cells. The testing is done by pathologists. Pathologists are doctors who look for disease in cells, fluids and tissue removed from the body.

Results are often given in a pathology report. The results may show:

• Cell type. The results show whether the cancer cells are ductal cells, lobular cells or other kinds of cells. Invasive ductal carcinoma contains ductal cells.
• Cell grade. The grade of the breast cancer cells is based on how the cells look under a microscope. The grade tells the healthcare team whether the cancer is likely to grow slowly or quickly.
• Hormone receptor status. Most breast cancer cells use the hormones estrogen and progesterone to help them grow. Cells that do this have receptors that help them catch the hormones circulating in the bloodstream. If testing finds receptors for one or both hormones, the cancer is hormone receptor positive. If testing doesn't find receptors, then the cancer is hormone receptor negative.
• HER2 status. Some breast cancer cells use a protein called human epidermal growth factor receptor 2 (HER2) to help them grow. Healthy breast cells make some HER2, but the cancer cells can make a lot more. If tests show the cancer cells have extra copies of the HER2 gene or increased levels of the HER2 protein, the cancer is HER2 positive. If testing doesn't find these, the cancer is HER2 negative.
• Ki-67 score. Ki-67 is a protein that marks how fast the cancer cells divide, also called the proliferation rate. The Ki-67 score goes from 0% to 100%. A higher score suggests a higher rate of dividing cells and faster growth.

The healthcare team uses the results from lab tests to decide on the cancer's stage, understand the prognosis and make a treatment plan.

Staging tests

Once your healthcare team diagnoses invasive ductal carcinoma, you may have other tests to figure out the extent of the cancer. This is called the cancer's stage. Your healthcare team uses your cancer's stage to understand your prognosis.

Complete information about your cancer's stage may not be available until after breast cancer surgery.

Tests and procedures used to stage breast cancer may include:

• Blood tests, such as a complete blood count and tests to show how well the kidneys and liver are working.
• Bone scan.
• CT scan.
• MRI.
• Positron emission tomography (PET) scan.

Not everyone needs all of these tests. Your healthcare team picks the right tests based on your specific situation.

Invasive ductal carcinoma uses the same stages as other types of breast cancer. Breast cancer stages range from 0 to 4. A lower number means the cancer is less advanced and more likely to be cured. As the cancer grows into the breast tissue and gets more advanced, the stages get higher.

A cancer's grade is a number that tells the healthcare team how different the cancer cells look from healthy cells. The grades of invasive ductal carcinoma (IDC) go from 1 to 3.

To decide on the grade, doctors in the lab, called pathologists, use a microscope to look at the cancer cells from a biopsy. If the cancer cells look similar to healthy cells, then the cancer cells are low grade. Low-grade cancer grows slowly. If the cancer cells look very different from healthy cells, then the cancer cells are high grade. High-grade cancer grows quickly.

The grades of invasive ductal carcinoma include:

• Grade 1. Grade 1 is a low grade. The cancer cells look similar to healthy cells. Grade 1 invasive ductal carcinoma typically grows slowly and has a low risk of spreading. It's sometimes called well-differentiated cancer.
• Grade 2. Grade 2 is an intermediate grade. The cancer cells look a little different from healthy cells. Grade 2 invasive ductal carcinoma grows more quickly than grade 1 cancer. It also has a higher risk of spreading. Sometimes it's called moderately differentiated cancer.
• Grade 3. Grade 3 is a high grade. The cancer cells look very different from healthy cells. Grade 3 invasive ductal carcinoma is considered a fast-growing cancer. It has the highest risk of spreading. Sometimes it's called poorly differentiated cancer.

The grade helps the healthcare team understand the prognosis and make a treatment plan. High-grade cancers are more likely to spread, so they may need more intense treatment. Grade 1 or 2 invasive ductal carcinoma cells are more likely to have hormone receptors and respond to estrogen blocker therapy. Grade 3 cancers are more likely to respond to chemotherapy.

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:

• 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.
• 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.
• 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.

Learning you have invasive ductal carcinoma (IDC) can be unexpected, and it's natural to have questions about what comes next. You may be receiving a lot of information and facing decisions about surgery, radiation and medical treatments. It's common to have a range of feelings that may change from day to day, and it can take time to process everything. As you move forward, here are some ideas that might be helpful.

Learn enough to make decisions about your care

If you'd like to know more about your breast cancer, ask your healthcare team for the details. Write down the type, stage and hormone receptor status. Ask for good sources of information where you can learn more about your treatment options.

Knowing more about your cancer and your options may help you feel more confident when making treatment decisions. Still, some people don't want to know the details of their cancer. If this is how you feel, let your care team know that too.

Talk with other breast cancer survivors

You may find it helpful and encouraging to talk to others who have been diagnosed with breast cancer. Ask your healthcare team about support groups in your area, or contact the American Cancer Society or another cancer organization in your area to find resources. Find support online through Mayo Clinic Connect, a community where you can connect with others for support, practical information and answers to everyday questions.

Find a good listener

Finding someone who is willing to listen to you talk about your hopes and fears can be helpful as you manage a cancer diagnosis. This could be a friend or family member. A counselor, medical social worker or clergy member also may offer helpful guidance and care.

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you. If an exam or imaging test shows you might have breast cancer, your healthcare team will likely refer you to a specialist.

Specialists who care for people with breast cancer include:

• Breast health specialists.
• Breast surgeons.
• Doctors who specialize in diagnostic tests, such as mammograms, called radiologists.
• Doctors who specialize in treating cancer, called oncologists.
• Doctors who treat cancer with radiation, called radiation oncologists.
• Genetic counselors.
• Plastic surgeons.

What you can do to prepare

• Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Write down your family history of cancer. Note any family members who have had cancer. Note how each member is related to you, the type of cancer, the age at diagnosis and whether each person survived.
• Make a list of all medicines, vitamins or supplements that you're taking.
• Keep all of your records that relate to your cancer diagnosis and treatment. Organize your records in a binder or folder that you can take to your appointments.
• Consider taking a family member or friend along. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your healthcare professional.

Questions to ask your doctor

Your time with your healthcare professional is limited. Prepare a list of questions so that you can make the most of your time together. List your questions from most important to least important in case time runs out. For breast cancer, some basic questions to ask include:

• What type of breast cancer do I have?
• What is the stage of my cancer?
• Can you explain my pathology report to me? Can I have a copy for my records?
• Do I need any more tests?
• What treatment options are available for me?
• What are the benefits from each treatment you recommend?
• What are the side effects of each treatment option?
• Will treatment cause menopause?
• How will each treatment affect my daily life? Can I continue working?
• Is there one treatment you recommend over the others?
• How do you know that these treatments will benefit me?
• What would you recommend to a friend or family member in my situation?
• How quickly do I need to make a decision about cancer treatment?
• What happens if I don't want cancer treatment?
• What will cancer treatment cost?
• Does my insurance plan cover the tests and treatment you're recommending?
• Should I seek a second opinion? Will my insurance cover it?
• Are there any brochures or other printed material that I can take with me? What websites or books do you recommend?
• Are there any clinical trials or newer treatments that I should consider?

In addition to the questions that you've prepared, don't hesitate to ask other questions you think of during your appointment.

What to expect from your doctor

Be prepared to answer some questions about your symptoms and your health, such as:

• When did you first begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• Has a mammogram ever detected something concerning?
• Have you ever had a breast biopsy?

Staging is a way to describe the size of the cancer and whether it has spread. Staging helps your healthcare team understand your prognosis. It also helps your team create a treatment plan that fits your cancer. The stages of invasive ductal carcinoma (IDC) are the same as the stages used for other types of breast cancer.

Staging information

To stage the breast cancer, the healthcare team collects as much information about the cancer as possible. The information comes from the exams and imaging tests you've had, as well as the biopsy report from the pathologist.

Information used in staging includes:

• The size of the cancer in the breast.
• Whether cancer cells have spread to the lymph nodes or other parts of the body.
• The cancer's grade.
• The cancer's hormone receptor status.
• The cancer's HER2 status.
• The presence of certain genes that might impact treatment options.
• Other pieces of information that may become available after the cancer is removed during surgery.

Types of staging

The process of breast cancer staging can take place at different times after diagnosis and around treatment. Your stage may change as your care team gets more information about your cancer.

Healthcare professionals use different types of stages at different times.

• Anatomic staging happens after a breast biopsy confirms cancer. It tells your care team about the size of the cancer and whether it has spread. It does not take cancer grade, hormone receptor status or HER2 status into account.
• Clinical prognostic staging happens after all tests on your biopsy sample are complete and your care team knows your cancer grade, hormone receptor status and HER2 status. The prognostic staging process tells your care team more about whether the cancer responds to medical treatment. It helps the team choose the first treatment.
• Pathological prognostic staging is used after surgery once the cancer is removed. This kind of staging looks at factors such as the size of the cancer removed during surgery and the number of lymph nodes removed that contain cancer.
• Postneoadjuvant therapy prognostic staging is used when you receive medicine as your first treatment for breast cancer. This staging process considers the status of the cancer after the medicine is given. It can help your care team decide what to do next.

Because there are several types of stages that consider different factors, the stages of breast cancer can be confusing and complicated. Ask your healthcare team to explain your stage and what it means for your treatment.

Anatomic stages

Anatomic staging is the simplest form of breast cancer staging. To decide on the anatomic stage, the healthcare team uses the size of the cancer and whether it has spread. Using this type of staging, the stages go from 0 to 4.

• Stage 0. Cancer cells have not grown beyond the ducts. This cancer does not spread. Ductal carcinoma in situ is a stage 0 noninvasive cancer.
• Stage 1. The cancer in the breast is less than 1 inch (2 centimeters) in diameter. Cancer cells have spread beyond the ducts into the breast tissue. There is little or no evidence of cancer in the lymph nodes. Cancer has not spread elsewhere in the body.
• Stage 2. The cancer in the breast is less than 2 inches (5 centimeters) in diameter and has spread to some underarm lymph nodes. Or the cancer is larger than 2 centimeters in diameter and has not spread to the underarm lymph nodes.
• Stage 3. The cancer in the breast is any size and has spread to many underarm lymph nodes. Or the cancer is larger than 2 inches (5 centimeters) in diameter and has spread to some underarm lymph nodes. This stage also includes cancers that spread to the skin, the chest beyond the muscle, or the lymph nodes inside the chest wall. Inflammatory breast cancer is considered a stage 3 cancer.
• Stage 4. The cancer in the breast is any size and cancer cells have spread to sites away from the breast and nearby lymph nodes. These sites may include the brain, bones, lungs or liver.

The anatomic stage may be the first stage your healthcare team talks about after your diagnosis. The stage may change as your team gets more information about your cancer, such as the hormone receptor status.

The survival rates for invasive ductal carcinoma (IDC) and other types of breast cancer are quite good, especially when the cancer is caught early. Most people with this diagnosis have an early-stage cancer and good prognosis. Many are cured. Even when a cure isn't possible, treatments often can slow the cancer's growth and extend your life.

Survival statistics

Cancer survival rates come from studying many people with the same cancer to see how many are living five years after diagnosis. The survival rate can give you an idea about survival for people in your situation. But the numbers can't predict your personal chances of survival.

Survival rates for invasive ductal carcinoma are the same as survival rates for breast cancer in general, since most breast cancers are invasive ductal carcinomas.

The U.S. National Cancer Institute (NCI) tracks cancer survival rates in the United States. NCI breaks down the rates by how far the cancer has spread, rather than by stage.

• Localized cancer, which means the cancer is only in the breast, has a 5-year survival rate of 100%.
• Regional cancer, which means the cancer has spread to nearby lymph nodes, has a 5-year survival rate of 88%.
• Distant cancer, which means the cancer has spread to other parts of the body, has a 5-year survival rate of 34%.

These are the survival rates for breast cancer in general. Survival rates vary greatly depending on whether the cancer cells have hormone receptors or make extra HER2.

Prognosis

Cancer prognosis describes how likely it is that a cancer can be treated successfully or cured. It is based on the details of your cancer, as well as your overall health. If you want to understand your personal prognosis, talk with your healthcare team. Your team can walk you through the factors they consider and explain what those mean for you.

Having an invasive ductal carcinoma generally doesn't affect prognosis. This type of cancer has a similar prognosis to the other main type, called invasive lobular carcinoma.

Things that can affect the prognosis for invasive ductal carcinoma and other breast cancers include:

• Age at diagnosis. Breast cancer that happens in younger people, such as those 35 and younger, tends to grow more quickly. Breast cancer diagnosed at a later age, such as after menopause, tends to have a better prognosis.
• Cancer grade. Grade 1 and 2 cancers tend to grow more slowly and have a better prognosis than grade 3 cancers.
• HER2 status. Cancer cells that make extra HER2 tend to grow faster. But there are many treatments that target HER2. Because treatment is so effective, having a HER2-positive breast cancer gives a better prognosis.
• Hormone receptor status. Cancer cells that don't have receptors for the hormones estrogen and progesterone have fewer treatment options because these cancers don't respond to estrogen blocker therapy. If the cancer is hormone receptor positive, the prognosis is better. Researchers are studying new treatment options for hormone receptor negative cancers.
• The size of the cancer in the breast. A small cancer may be easier to remove completely and have a lower risk of spreading, so it has a better prognosis.
• Whether the lymph nodes contain cancer. Cancer that spreads to the lymph nodes has a higher risk of spreading to other parts of the body. If the cancer hasn't spread to the lymph nodes, the prognosis is better.

What you can do

After treatment, healthcare professionals often recommend making healthy choices that are good for anyone who wants improved health: Eat a balanced diet, exercise, maintain a weight that's healthy for you and limit the amount of alcohol you drink. For people with breast cancer, these healthy choices also might lower the risk of recurrent breast cancer.

Try to:

• Avoid alcohol. Research links drinking alcohol to a higher risk of breast cancer, but it's not clear whether alcohol raises the risk of the cancer coming back. If you choose to drink alcohol, limit how often you drink and keep the amount small. For overall health, drink one or fewer drinks a day. Do not drink every day. The less you drink, the better.
• Follow a healthy diet. Choose a diet that's rich in fruits, vegetables and whole grains. Limit how much red meat, processed meat and sugar you eat.
• Stay active. Aim to exercise most days of the week. If you don't exercise regularly, get your healthcare professional's OK first. Start out with short sessions of an activity you enjoy and build up the amount of exercise over time.
• Strive for a healthy weight. Ask your healthcare professional what weight is healthy for you. If your weight is healthy, work to maintain it. If you need to lose weight, aim to do so slowly. Start by making healthy choices, such as eating fewer calories, moving more and sitting less.

Talk with your healthcare team about other things you can do to lower your risk of recurrence. Also follow your care team's advice on follow-up exams and tests after you finish cancer treatment.