From the Guidelines
Invasive ductal carcinoma grade 1 is typically treated with surgery, such as lumpectomy or mastectomy, followed by radiation therapy and hormone therapy if the tumor is hormone receptor-positive, as seen in the case presentation of a 54-year-old woman with clinical T3N0M0, estrogen receptor–positive, human epidermal growth factor receptor 2–negative, Nottingham grade 1 invasive ductal carcinoma 1.
Key Considerations
- The grade 1 classification indicates that the cancer cells look similar to normal cells and are growing slowly, which generally means a better prognosis compared to higher grades.
- Treatment typically involves surgery (lumpectomy or mastectomy) with sentinel lymph node biopsy, often followed by radiation therapy if a lumpectomy was performed.
- Hormone therapy such as tamoxifen or aromatase inhibitors is usually recommended for 5-10 years if the tumor is hormone receptor-positive, which is common in grade 1 tumors.
- Chemotherapy is less commonly needed for grade 1 tumors unless other high-risk features are present, as noted in the case presentation where the patient received neoadjuvant chemotherapy with paclitaxel, doxorubicin, and cyclophosphamide 1.
Management and Follow-up
- Regular follow-up appointments, typically every 3-6 months for the first few years, are essential for monitoring.
- The 5-year survival rate for early-stage invasive ductal carcinoma is very good, often exceeding 90%, as supported by the most recent guidelines and studies, although specific survival rates for grade 1 tumors are not provided in the given evidence.
- The patient's treatment plan, including postmastectomy radiation and hormone therapy with tamoxifen and later letrozole, is consistent with current recommendations for hormone receptor-positive invasive ductal carcinoma 1.
Evidence-Based Recommendations
- The most recent study from 2022 provides a case presentation of a patient with invasive ductal carcinoma grade 1, highlighting the importance of individualized treatment planning and regular follow-up 1.
- While the 2010 guidelines from the National Comprehensive Cancer Network provide recommendations for the treatment of ductal carcinoma in situ (DCIS), they are not directly applicable to invasive ductal carcinoma grade 1 1.
From the Research
Invasive Ductal Carcinoma Grade 1
- Invasive ductal carcinoma (IDC) is the most common type of breast cancer, and grade 1 is considered an early stage of the disease 2.
- The causes of IDC include mutations on BRCA1 and BRCA2, different levels of expression of specific genes in signaling pathways, menopause status, alcohol consumption, aging, and hormone imbalances 2.
- Prompt IDC diagnosis and early intervention have been reported to demonstrate a greater probability of eradicating IDC and preventing further recurrence in the future 2.
- There is no direct information available in the provided studies regarding the specific treatment and prognosis of invasive ductal carcinoma grade 1.
- However, studies on ductal carcinoma in situ (DCIS) suggest that treatment with lumpectomy and radiotherapy can reduce the risk of local invasive recurrence and breast cancer mortality 3, 4.
- The use of radiotherapy in patients with DCIS has been associated with a significant reduction in breast cancer mortality compared with either lumpectomy alone or mastectomy alone 3.
- Lumpectomy plus radiation has been shown to be more beneficial than lumpectomy alone for women with localized DCIS, reducing the incidence of invasive and noninvasive ipsilateral breast tumors (IBTs) 4.