Ductal carcinoma is a condition in which cancerous cells begin developing in the milk ducts of one’s breasts. Ductal carcinoma in situ occurs when cancer cells remain in the milk ducts; however, when they spread to the breast tissue, the condition is called invasive ductal carcinoma. Once these malignant cells reach the breast tissue, they can spread to other organs, causing metastatic breast cancer. Fortunately, timely management can prevent or arrest its spread.

Causes and possible triggers

1. Hereditary factors
About 5–10% of ductal carcinoma cases are hereditary in patients, and mutations to specific genes, like breast cancer gene  1  (BRCA1), breast cancer gene 2 (BRCA2), PALB2, and ATM, are known to trigger its development. Generally, women with family members who have been diagnosed with the disease have higher chances of developing it.

2. Hormone therapy
Some studies show that if a person has undergone hormone therapy, particularly with the hormones estrogen and progestin, a form of progesterone, they are at a higher risk of invasive breast cancer than those who haven’t taken such treatments.

3. Dense breast tissues
While high breast density is not a disease or condition in itself, it might increase one’s vulnerability to breast cancer, including ductal carcinoma.

4. Sedentary lifestyle
A sedentary lifestyle is shown to increase the risk of breast cancer in general, including making one more susceptible to ductal carcinoma. Having unhealthy foods regularly further increases the risk factor.

Symptoms of ductal carcinoma

1. Lump or spongy area in the breast
Ductal carcinoma in situ may cause a breast lump that can be identified by a mammogram. It may not always resemble a proper lump; sometimes, an abnormal spongy area may be visible on the breast.

2. Pain and swelling
Breast pain and inflammation are common symptoms of ductal carcinoma and might be accompanied by excessive firmness or tenderness in one of the breasts.

3. Changes in nipple position
Sometimes, patients with ductal carcinoma may find a change in the position of their nipples, which may suddenly look inverted or retracted.

4. Nipple discharge
Many patients with breast cancer, in general, and specifically with ductal carcinoma, may experience discharge from the nipples. This discharge may be clear or comprise blood.

5. Swollen lymph nodes
As ductal carcinoma begins spreading, one’s lymph nodes may swell, which is a sign that cancer has spread to this area.

Diagnostic procedures

1. Mammogram
A mammogram is among the most common diagnostic procedures for ductal carcinoma. Here, low-energy X-rays are used to formulate an image of the internal part of one’s breasts. With this image, doctors can identify whether a person has any internal signs of ductal carcinoma in situ, such as lumps and skin thickening.

2. Breast ultrasound
Here, sound waves are used to create an image of the internal part of the breasts, as well as the tissues and lymph nodes surrounding them. This way, doctors can not only detect cancerous cells in the breast ducts but also check if these cells have begun spreading to other body parts.

3. Physical breast examination
For many patients with ductal carcinoma, breast lumps may either not form at all or resemble a spongy area on the breast. So, doctors might want to physically exam ine the breasts to identify whether there are any changes in their shape, position, texture, etc., to diagnose the condition.

4. Biopsy
In the case of a biopsy, the diagnostician extracts a tissue sample from one’s breast and examines it to determine whether a person has ductal carcinoma. Biopsies help healthcare providers understand the appropriate treatment course.

Treatment options

1. Chemotherapy
Chemotherapy may be administered orally or intravenously to patients with breast cancer to treat the condition. Also, it may sometimes be prescribed by doctors to destroy any cancer cells that may have remained after surgery has been performed for the condition.

2. Radiation therapy
Here, intense energy is directed toward the breasts to destroy cancer cells. Similar to chemotherapy, one may receive radiation to kill any malignant cells that may have been left behind after surgery. Although a radiation therapy course usually lasts for five weeks, some intense courses may go on for about seven weeks.

3. Surgery
When radiation and chemotherapy aren’t effective independently, doctors may recommend surgery to destroy carcinogenic cells. In the case of surgery for ductal carcinoma, the entire breast may have to be removed in most cases, as removing only the tissue may not be effective in curbing the disease.

4. Targeted therapy
Here, the specific elements of a cancer-causing cell are targeted and destroyed. For example, since the HER2 protein causes the spread of breast cancer, targeted therapy may aim to destroy this protein so that the cancer cell does not sustain and multiply in the body.

5. Immunotherapy
This therapy focuses on strengthening one’s immune system to develop the ability to destroy cancer cells. Although immunotherapy may not be used in isolation, it might boost the effectiveness of other interventions based on how serious ductal carcinoma is.

When ductal carcinoma is diagnosed at its grade 1 stage, its treatments are far more effective and less complex than at the later stages. Besides consulting a doctor early and undertaking the prescribed treatment, those with ductal carcinoma should lead healthy lifestyles to support recovery from the condition. A sedentary lifestyle can worsen the disease, so one should engage in walking, jogging, stretching, and other low-intensity workouts even when under treatment. A balanced, nutrient-rich meal plan rich in fruits, vegetables, whole grains, eggs, lean meats, nuts, etc. must boost immunity and alleviate treatment side effects.