​Ductal Carcinoma

Ductal carcinoma is a type of breast cancer that develops in the lining of the milk duct within the breast. It can occur in either of the two forms:

  • Ductal carcinoma in situ (DCIS): this is the stage zero of breast cancer as it is found in and limited to the milk duct of the breast. Consequently it is also considered as non-invasive as it has not spread out to affect other parts of the body.

  • Invasive ductal carcinoma (IDC): this begins in the duct of the breast and then spreads out to affect the tissue outside of the duct as well.  It is the most common form of breast cancer in diagnosed cases.

Possible causes of ductal carcinoma include family history, increasing age and obesity.

There are no symptoms for ductal carcinoma in situ and it can only be detected by a mammogram, hence it is a good idea to have breast screenings performed at regular intervals.

Contrarily, the presence of the following can give an indication of invasive ductal carcinoma:

  • Lump in the breast or the underarms

  • Development of thick breast skin

  • A rash on the breast

  • The swelling of one breast

  • Pain experienced in one breast

  • Pain in the nipple

  • Discharge from the nipple​

Consult your doctor if you feel any change in your breast. Alternatively, you can consult the qualified staff of the Oncology Service Line​ at The Aga Khan University Hospital.

To seek medical advice from a specialist, you can request an appointment at the Breast Clinic.​
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​

The first step in a diagnosis for ductal carcinoma is a mammogram, where an x-ray is used to examine the tissue in your breast. Based on the result of the mammogram, if the doctor feels there is a need for further examination, the following may be done:

  • Needle biopsy: a hollow needle is used to extract tissue from your breast for further examination

  • Stereotactic biopsy: again a hollow needle is used to extract tissue from your breast. However the area from where it is taken is identified with the use of stereo images taken from a mammogram

  • Surgical biopsy: if a wider sample is required, a surgery may be performed to extract more tissue from your breast​

As ductal carcinoma is the earliest form of breast cancer, it has great chances of being contained and removed. A number of options are available for the treatment of ductal carcinoma and your doctor may recommend any one of these following procedures:

  • Lumpectomy – this involves removal of the affected tissue from your breast along with a certain portion of healthy tissue. Subsequently radiation therapy is also performed to ensure that the tumour does not reoccur.

  • Mastectomy – another form of surgery, this removes not only the affected tissue and some normal tissue around it, but also the skin, areola, nipple and the underarm lymph nodes. Due to the success of lumpectomy, this procedure is being performed less and less.


For invasive ductal carcinoma, additionally the following treatments may be undertaken:

  • Breast reconstruction – this is surgical procedure to reconstruct and improve the appearance of your breast following a lumpectomy.

  • Radiation – this form of treatment used powerful energy sources, such as X-rays, in order to shrink large tumours prior to surgery, to eliminate cancer cells that may still remain following surgery, or in order to reduce the symptoms of cancer. This is usually used on patients who have undergone a lumpectomy surgery.

  • Chemotherapy – this involves administering drugs, either taken orally in the form of pills or injected directly into your bloodstream, with aim to destroy cancerous cells.

  • Hormonal therapy – this form of treatment is taken in the form of an oral pill which is either a form of selective oestrogen receptor modulator (SERM) or an aromatase inhibitor (AI). These help to block the ability of your oestrogen to reach cancerous cells which thus inhibits the growth of breast cancer cells in your body.

  • Biologic therapy – biologic targeted therapy or targeted therapy are drugs which are taken in order to alter the behaviour of breast cancer cells.​

The Agha Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
 
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.
 
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​
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The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.