Invasive ductal carcinoma
Invasive ductal carcinoma not otherwise specified, also known as invasive carcinoma of no special type, is the most common type of breast cancer. It is an infiltrating, malignant and abnormal proliferation of neoplastic cells in the breast tissues.
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Terminology
The latest (4th) edition of the World Health Organization classification of tumors of the breast changed the preferred terminology from invasive ductal carcinoma, not otherwise specified (NOS) to invasive (breast) carcinoma of no special type (NST) 4. The rationale is that the use of 'ductal' relies on unproven histogenetic assumptions for this heterogeneous group of cancers. Invasive ductal carcinoma or ductal NOS remains acceptable and commonly used terms.
Epidemiology
Peak age of presentation is about 50 to 60 years.
Clinical presentation
Large palpable, immobile mass.
Radiographic features
Mammogram
- spiculated hyperdense lesion
- oval/lobulated lesion
- microcalcifications
Ultrasound
- ill-defined lesion
- hypoechoic mass
- hyperechoic angular margins
- posterior acoustic shadowing
- ductal extension may be seen which is extension of the lesion into surrounding parenchyma
- branched or spiculated pattern
- microcalcifications
MRI
-
T1
- isointense to parenchyma
- hypointense to fat
-
T1 C+ (Gd)
- ring enhancement with centripetal progression
- dilated veins draining the tumor
-
T2
- iso to hypointense to parenchyma
- hyperintense edematous zone
Related Radiopaedia articles
Breast imaging and pathology
- breast screening
-
mammography
- breast imaging and the technologist
- forbidden (check) areas in mammography
-
mammography views
- craniocaudal view
- mediolateral oblique view
- additional (supplementary) views
- true lateral view
- lateromedial oblique view
- late mediolateral view
- step oblique views
- spot view
- double spot compression view
- magnification view
- exaggerated craniocaudal (axillary) view
- cleavage view
- tangential views
- caudocranial view
- bullseye CC view
- rolled CC view
- elevated craniocaudal projection
- caudal cranial projection
- 20° oblique projection
- inferomedial superolateral oblique projection
- Eklund technique
- normal breast imaging examples
- digital breast tomosynthesis
- breast ultrasound
- breast ductography
- breast MRI
- breast morphology
- breast intervention
- breast pathology
- malignant lesions
-
breast cancer
- breast adenocarcinoma
- ductal breast carcinoma
- ductal carcinoma in situ (DCIS)
- invasive ductal carcinoma
- lobular breast carcinoma
- ductal breast carcinoma
- adenoid cystic carcinoma of the breast
- apocrine carcinoma of the breast
- breast cancer metastases
- breast lymphoma
- breast sarcoma
- inflammatory carcinoma of breast
- intracystic breast cancer
- male breast cancer
- malignant phyllodes tumor
- metastases to the breast
- metaplastic carcinoma the breast
- gamuts
- breast adenocarcinoma
-
breast cancer
- borderline breast disease / high risk breast lesion
- benign lesions
- adenosis of the breast
- benign papillary lesions of the breast
- breast cyst
- breast hematoma
- breast hamartoma
- breast lipoma
- ductal adenoma of the breast
- epidermal inclusion cysts of the breast
- fat necrosis of the breast
- fibroadenoma
- granular cell tumor of the breast
- gynecomastia
- lymphocytic mastitis
- mammary fibromatosis
- oil cyst
- phyllodes tumor
- post-surgical breast scar
- post-radiation breast changes
- post-traumatic fibrosis
- pseudoangiomatous stromal hyperplasia (PASH)
- pseudogynecomastia
- tubular adenoma
-
breast calcifications (approach)
- morphology
- distribution
- location
- lobular calcification within breast tissue
- intraductal calcification within breast tissue
- milk of calcium within a breast cyst
- vascular calcification in breast tissue
- skin (dermal) calcification in / around breast tissue
- suture calcification within breast tissue
- stromal calcification within breast tissue
- artifactual calcification from outside the breast
- suspicious breast calcifications
- infection/inflammation
- vascular lesions
- systemic disease
- gamuts
- classification systems
- malignant lesions
- breast cancer staging
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