Invasive breast cancer (no special type)

Invasive breast cancer (NST) is the most common type of breast cancer.

‘Invasive’ means the cancer cells have spread outside the ducts into the surrounding breast tissue.

NST stands for ‘no special type’.

It’s called ‘no special type’ because the cancer cells have no features that class them as a special type of breast cancer when examined under the microscope.

You may also hear it called:

• Invasive ductal carcinoma of the breast (IDC)
• Breast cancer not otherwise specified (NOS)

Sometimes invasive breast cancer (NST) is found mixed with other types of breast cancer.

Although it’s rare, men can get breast cancer. Invasive breast cancer (NST) is the most common type of breast cancer in men. 

Breast cancer is ‘invasive’ when cancer cells have spread outside the ducts into the surrounding breast tissue.

Symptoms of invasive breast cancer (NST) include: 

• A lump or thickening of the breast tissue 
• A change in the size or shape of the breast 
• A change of skin texture such as puckering or dimpling of the skin 
• A lump or swelling under the arm 
• Changes to the nipple, for example it has become pulled in (inverted) 
• Discharge from the nipple 
• Less commonly, a type of rash involving the nipple known as Paget’s disease of the breast 

Routine breast screening can often pick up cancer before a woman notices any symptoms. Therefore, some women will be diagnosed with invasive breast cancer (NST) after attending breast screening without having any of the symptoms above.

Invasive breast cancer (NST) is diagnosed using a range of tests. These may include: 

• A mammogram (breast x-ray) 
• An ultrasound scan (using sound waves to produce an image)
• A core biopsy of the breast and sometimes lymph nodes (using a hollow needle to take a small sample of tissue to be looked at under a microscope – several tissue samples may be taken at the same time) 
• A fine needle aspiration (FNA) of the breast and sometimes lymph nodes (using a fine needle and syringe to take a sample of cells to be looked at under a microscope)  

When there is a change to the skin or nipple a punch biopsy of the skin may be performed. This involves taking a very small cylindrical piece of tissue from the changed area.

As with all types of breast cancer, the treatments you’re offered will depend on the features of invasive breast cancer (NST) seen under the microscope. This includes the size, grade, hormone receptor status and HER2 status.

Treatment aims to remove the cancer and reduce the risk of it coming back or spreading to other parts of the body.

Surgery 

Surgery is usually the first treatment for invasive breast cancer (NST).  

There are 2 main types of surgery:

• Breast-conserving surgery, also known as wide local excision or lumpectomy – removal of the cancer with a margin (border) of normal breast tissue around it
• Mastectomy – removal of all the breast tissue, usually including the nipple area

The type of surgery recommended depends on:

• Where the cancer is in the breast
• The size of the cancer relative to the size of your breast
• Whether more than one area in the breast is affected

Sometimes after having breast-conserving surgery further surgery is needed if the margin of normal tissue surrounding the cancer that was removed is not clear. This is to ensure that all the cancer has been removed. In some cases, this second operation will be a mastectomy.

Most women who have a mastectomy will have the option to have breast reconstruction.

This can be done at the same time as your mastectomy (immediate reconstruction) or months or years later (delayed reconstruction).

Many women who have a mastectomy without breast reconstruction choose to wear a prosthesis – an artificial breast form that fits inside the bra. Find out more about breast protheses, bras and clothes after surgery.

Some women choose not to have reconstruction or wear a prosthesis.

Surgery to the lymph nodes

Your treatment team will want to check if any of the lymph nodes (glands) under the arm contain cancer cells. This, along with other information about your breast cancer, helps them decide whether you will benefit from any additional treatment after surgery.

To do this, your surgeon is likely to recommend an operation to remove either some of the lymph nodes (a sentinel lymph node biopsy or sample) or all of them (a lymph node clearance).

Find out more about surgery to the lymph nodes.

Adjuvant treatments

After surgery you will usually need further treatment. This is called adjuvant treatment and can include:

The aim of this treatment is to reduce the risk of breast cancer returning in the same breast, or spreading elsewhere in the body. 

Which treatments are recommended will depend on your individual situation.  

Some of these treatments are given before surgery. This is known as neo-adjuvant or primary treatment.   

You will continue to be monitored after your hospital-based treatments (such as surgery, chemotherapy or radiotherapy) finish. This is known as follow-up. 

Being diagnosed with breast cancer can be a difficult and frightening time.

If you’d like any further information and support or just want to talk things through, speak to one of our experts by calling our free helpline - please see further below.

Many people find it helps to talk to someone who has been through the same experience as them. Our Someone Like Me service can put you in touch with someone who has had a diagnosis of breast cancer, so you can talk through your worries and share experiences over the phone or by email - see below.

You can also visit our online forum and join one of the ongoing discussions.