Infiltrating breast cancer (or invasive ductal carcinoma) is an invasive breast cancer, that is to say that it leaves its development zone to invade other tissues. Cause of occurrence, treatment, operation, chances of survival: know everything.
Invasive breast cancer is invasive breast cancer : Cancer cells spread and invade the tissues surrounding the lobules or ducts of the breast where the tumor was formed. What is the exact definition? The causes of occurrence of such cancer in women? Reference treatments? The chances of survival?
What is invasive breast cancer?
Breast cancer is the most common type of cancer with 50,000 new cases per year. There are two types of breast cancer:
► Cancer says In situ: “It is a localized cancer, without risk of rupture of the membrane. Be careful though, unsupported this one can turn in invasive cancer“explains Dr. Didier Bourgeois, President of the Henri Hartmann Breast Institute
► Invasive breast cancer: It is an invasive cancer. “A membrane separates the cells from the vessels. When this is broken, cancer cells spread“, continues our interlocutor. Among invasive cancers, several subtypes exist depending on the aggressiveness and the mechanism of proliferation of the tumor. The two major subtypes are:
→ Ductal breast cancer found in 60% of cases and who is more aggressive
→ Lobular breast cancer found in 40% of cases and who is more indolent.
What causes invasive breast cancer?
“It is estimated that 15% of breast cancers have a genetic origin. 85% are therefore non-genetic and therefore have exogenous origins. It is believed that the factors of increase in breast cancers in our developed countries are: food, pollution, exposure to carcinogenic productss or endocrine disruptors. It is therefore important to adopt a healthy lifestyle even if we are well aware that patients who do not smoke, do not drink and eat organic food can also develop cancer”, list our expert.
The usefulness of screening to diagnose cancer as quickly as possible is essential. “The more cancer is discovered in screening, thanks to mammography, the greater the chances of recovery.“, assures the specialist. Two types of screening exist:
► Organized screening: This was generalized in France in 2004. It targets women aged 50 to 74. The latter are invited to have a mammogram and a clinical examination with a radiologist every two years.
► Individual screening: It is not necessary to wait to be part of the age range of organized screening to be screened. This can be done with the attending physician, the gynecologist or even the midwife.
If the presence of cancer is observed, the only way to know whether it is in situ or infiltrating cancer is to practice a biopsy. “This biopsy will make it possible to draw up the identity card of the cancer and to know how aggressive it can be“, explains Dr. Bourgeois.
What are the treatments for invasive breast cancer?
Depending on the characteristics of the cancer, doctors start the treatment protocol with chemotherapy or surgery. However, “chemotherapy is used much less in cases of lobular cancers than in cases of ductal cancers because lobular cancers are more indolent“, specifies the gynecological surgeon; To choose chemotherapy as the first treatment, two major indications are taken into account:
► To begin with, Infiltrating cancer is analyzed according to three elements: the sensitivity of estrogen receptors, progesterone and the HER2 protein. When these three elements are not present, it is called “triple negativity“and that’s a sign of a highly aggressive cancer because the cell has dedifferentiated.”This means that the cell is so different from its original cell that it becomes mad and therefore aggressive..”
Breast cancer cannot be cured without surgery.
► The second indication which encourages specialists to start treatment with chemotherapy is the presence of cancer that would require removing the breast entirely. “So we start with chemotherapy to melt the lesion and when it measures about 1 cm, we can then remove it while keeping the breast“, he explains.
However, surgery is the cornerstone of breast cancer treatment. “Breast cancer cannot be cured without surgery. The only women who are not operated on are women whose cancer is metastatic – that is to say that it has spread to other parts of the body – and for whom we are unable to control the disease. You have to control the metastatic disease first and then you can operate.”explains the specialist. Treatment given after surgery may be proposed in order to minimize the risk of recurrence. These treatments are: radiation therapy, chemotherapy, hormone therapy, or immunotherapy.
There is a process called “genomic signature” which makes it possible to know which of these treatments would be the most effective. For this, specialists carry out genetic analyzes of the cancer. “This is an incredible advance because it reduces the number of unnecessary chemotherapy treatments. Out of 100 patients who used chemotherapy, 30 to 40 could have been saved“, reports Dr. Bourgeois. Downside: this examination is not covered by social security and costs the patient around 2000 euros.”In certain specialized institutes, the analyzes are carried out at the expense of the establishment. But many patients do not take advantage of it, for lack of means. We are fighting for this to become systematic and to be reimbursed“, he underlines.
What are the chances of survival in case of invasive breast cancer?
“Currently, the cure rate for all breast cancers combined is 88%. But this percentage means nothing since each year, 14,000 women die of their cancer. If metastatic cancer has a lower chance of cure, today we know that we are able to cure it“, however, reassures the specialist.
Thanks to Dr Didier Bourgeois, gynecological surgeon specializing in the management of breast cancer, president of the Henri Hartmann breast institute