41. Invasive ductal carcinoma

Last updated on May 2, 2019 at 10:55

Staining: HE

Organ: Breast


Normal breast tissue, including lots of adipose tissue, is visible on the left and right sides of the slide. In the middle is the invasive tumor. The tumor has a desmoplastic (fibrotic) neostroma, and the gland-like structures show mild atypia.

DCIS, the precursor lesion of invasive ductal carcinoma, is also visible on the top of the slide. It’s a large, dilated duct that is filled with tumor cells. Its myoepithelial cell layer is intact, which is the difference between DCIS and invasive carcinoma.

On the left of the slide apocrine metaplasia is visible. The cells of the ducts resemble apocrine sweat glands. These cells are larger than normal, have abundant eosinophilic cytoplasm, round nuclei and prominent nucleoli.

Diagnosis: Invasive ductal carcinoma

Risk factors for breast cancer:

  • Nulliparity
  • Excess oestrogen
  • Familial BRCA gene mutations
  • Positive family history


The desmoplastic neostroma makes the tumor firm and therefore palpable.

The degree of differentiation of the gland-like structures the tumor forms decides the grade of the tumor. The grading system is called the Bloom-Richardson grading system.

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40. Paget disease

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42. Mucinous carcinoma

5 thoughts on “41. Invasive ductal carcinoma”

  1. according to Dr. bela there is apocrine metaplasia in the ducts , its seen in the left part of the slide near the normal breast tissue . ( I dont know if they will ask about it or not ) , good luck for the exam period .

  2. I’m sorry, but I don’t understand something… If we see a DCIS on the slide, why the topic’s title is invasive ductal carcinoma (IDC)? Where can we see the invasive parts?

  3. Oh, I think I understand now, the DCIS is only the little basophil cell-group on the top of the carcinoma. Sorry for disturbing you!

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