Invasive Ductal Carcinoma Diagnosis

Invasive ductal carcinoma (IBC) is most commonly seen on a mammogram or through other tests ordered when symptoms are present.

If IDC is suspected on a mammogram, a biopsy may be ordered.

Symptoms of Invasive Ductal Carcinoma (ICD)

IDC may be discovered on a mammogram before presenting any symptoms. However, some women may have symptoms including:

  • Changes in the breast shape
  • Breast or nipple pain
  • Discharge from the nipple
  • Swelling of the breast
  • A lump
  • Thickening of the nipple skin

Staging for IDC

Invasive ductal carcinoma (IDC) can be described as a stage 1 (earliest stage) to a stage IV (most advanced stage), depending on the size of the tumor and how far it has spread. 

Stage 1

The tumor is 2 cm (about 3/4 of an inch) or less across and has not spread to lymph nodes or distant sites.

Stage IB

The tumor is 2 cm or less across (or is not found) with micrometastases in one to three axillary lymph nodes (the cancer in the lymph nodes is greater than 0.2mm across and/or more than 200 cells but is not larger than 2 mm). The cancer has not spread to distant sites.

Stage IIA

One of the following applies and the cancer hasn't spread to distant sites:

  • The tumor is 2 cm or less across (or is not found) and has spread to one to three axillary lymph nodes, with the cancer in the lymph nodes larger than 2 mm across.
  • The tumor is 2 cm or less across (or is not found) and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.
  • The tumor is 2 cm or less across (or is not found) and has spread to one to three lymph nodes under the arm and to internal mammary lymph nodes (found on sentinel lymph node biopsy).
  • The tumor is larger than 2 cm across and less than 5 cm but hasn't spread to the lymph nodes.

Stage IIB

One of the following applies and the cancer hasn't spread to distant sites:

  • The tumor is larger than 2 cm and less than 5 cm across. It has spread to one to three axillary lymph nodes and/or tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.
  • The tumor is larger than 5 cm across but does not grow into the chest wall or skin and has not spread to lymph nodes.

Stage IIIA

One of the following applies and the cancer hasn't spread to distant sites:

  • The tumor is not more than 5 cm across (or cannot be found). It has spread to four to nine axillary lymph nodes, or it has enlarged the internal mammary lymph nodes.
  • The tumor is larger than 5 cm across but does not grow into the chest wall or skin. It has spread to one to nine axillary nodes, or to internal mammary nodes.

Stage IIIB

The tumor has grown into the chest wall or skin but hasn't spread to distant sites, and one of the following applies:

  • It has not spread to the lymph nodes.
  • It has spread to one to three axillary lymph nodes and/or tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.
  • It has spread to four to nine axillary lymph nodes, or it has enlarged the internal mammary lymph nodes.

Stage IIIC

The tumor is any size (or can't be found), hasn't spread to distant sites and one of the following applies:

  • Cancer has spread to 10 or more axillary lymph nodes.
  • Cancer has spread to the lymph nodes under the clavicle (collar bone).
  • Cancer has spread to the lymph nodes above the clavicle.
  • Cancer involves axillary lymph nodes and has enlarged the internal mammary lymph nodes.
  • Cancer has spread to four or more axillary lymph nodes, and tiny amounts of cancer are found in internal mammary lymph nodes on sentinel lymph node biopsy.

Stage IV

The cancer can be any size and may or may not have spread to nearby lymph nodes. It has spread to distant organs or to lymph nodes far from the breast. The most common sites of spread are the bone, liver, brain or lung.

IDC Second Opinion

If you were diagnosed at another health care center, and are coming to Penn Medicine’s Abramson Cancer Center for treatment, or for a second opinion, additional diagnostic tests may be necessary.

Penn uses specific diagnostic imaging tools, tests and procedures that are often more modern than what is available elsewhere. The results of these tools help us to develop your personalized treatment plan.

In advance of your second opinion, we may request:

  • Pathology slides
  • Copies of recent images (CT scans, for example)
  • Health records
  • A list of dates and facts about your past treatments, personal health history, or any other facts and dates relevant to your current diagnosis

Come to your appointment with a list of as many questions as possible. Sometimes, it can be difficult to think of or remember everything during a visit. A list of questions prepared in advance will ensure you get the information you are looking for.

If you forget a question, or have more questions after your appointment, you can communicate with us via www.myPennMedicine.org, our secure patient portal. The portal allows for fluid communications with your entire team of health care providers.

Finally, plan to have a friend, family member or support person come with you to your diagnostic appointment. He or she can help take down information, recall the conversation and be of general support throughout the process.

IDC Diagnostic Tools

Penn Medicine uses modern diagnostic tools and tests to diagnose invasive ductal carcinoma.