Appointment dossier — Breast Invasive Ductal Carcinoma (IDC)
Bring this to your appointment. It summarizes what published studies report — it is not medical advice and does not say anything works. Decisions are yours and your care team’s.
Compounds studied in Breast Invasive Ductal Carcinoma (IDC)
- Carboplatin — Review evidence · 1 positive · PMID 37592269
- Doxorubicin — Animal evidence · 1 positive · PMID 35540837
- Fuzuloparib — Review evidence · 1 positive · PMID 34118019
- Genistein — Review evidence · 1 positive · PMID 42133114
- Olaparib — Review evidence · 1 positive · PMID 37592269
- Paclitaxel — Review evidence · 1 positive · PMID 37592269
- Tamoxifen — Review evidence · 0 positive / 1 negative-mixed · PMID 32906618
“Positive” means a study reported a positive result — most are early lab/animal work that may not translate to people.
Guideline-backed standard of care
Breast-conserving surgery (lumpectomy) + SLNB when feasible, Mastectomy when disease extent, multicentricity, prior RT, or patient preference dictates; nipple-sparing, Immediate reconstruction planning (implant or autologous), Z0011 approach: omit ALND with 1–2 positive SLNs if lumpectomy + whole-breast RT, Targeted axillary dissection post-NAT for initially node-positive patients (retrieve clipped node + SLNs) to accurately restage and potentially de-escalate ALND, Re-excision for positive margins; for invasive cancer, ‘no ink on tumor’, Place surgical clips in the tumor bed to guide boost RT and future imaging, Whole-breast irradiation (WBI) after lumpectomy, Tumor-bed boost for higher local-recurrence risk (younger age, close margins, high grade, extensive intraductal component), Post-mastectomy radiation (PMRT) for ≥4 positive nodes, Regional nodal irradiation (RNI) to axillary/supraclavicular ± internal mammary nodes based on nodal burden, biology, and response to NAT, Deep-inspiration breath hold (DIBH) for left-sided WBI/PMRT to reduce heart dose, Stereotactic radiosurgery (SRS) for limited brain metastases, Partial-breast irradiation (PBI), HR+/HER2– early: endocrine therapy (tamoxifen or aromatase inhibitor) ± ovarian function suppression (OFS) based on menopausal status and risk, Use genomic assays to decide on adjuvant chemotherapy in HR+/HER2– node-negative and select 1–3 node-positive patients undergoing upfront surgery, High-risk, node-positive HR+/HER2–: consider adjuvant abemaciclib + endocrine therapy per eligibility criteria, Postmenopausal HR+/HER2–: consider adjuvant bisphosphonates to reduce bone recurrence and fractures, Metastatic HR+/HER2–: endocrine therapy + CDK4/6 inhibitor, HER2+ stage II–III: neoadjuvant taxane-based ± anthracycline + trastuzumab/pertuzumab, Small node-negative HER2+ (e, Metastatic HER2+: first line taxane + trastuzumab + pertuzumab; second line trastuzumab deruxtecan (T-DXd) preferred; later lines, High-risk early TNBC: neoadjuvant anthracycline/taxane ± platinum with pembrolizumab, gBRCA-mutated, high-risk HER2– (HR+ or TNBC): consider 1 year of adjuvant olaparib per criteria, Metastatic TNBC: PD-L1–positive → pembrolizumab + chemotherapy; later lines, Ovarian protection: consider GnRH agonist during chemotherapy for premenopausal patients to reduce ovarian failure risk and preserve fertility, Oligometastatic disease: discuss consolidative local therapy (SBRT, surgery) after systemic response in a multidisciplinary tumor board, AC-T (doxorubicin/cyclophosphamide → paclitaxel) (early/high-risk), TC (docetaxel/cyclophosphamide) (early), THP / TCHP (taxane ± carboplatin + trastuzumab/pertuzumab) (HER2+ neoadjuvant), Capecitabine (post-neoadjuvant TNBC residual), CDK4/6 + endocrine therapy (AI or fulvestrant), Post-CDK4/6 progression: re-profile (tumor or ctDNA), Alpelisib for PIK3CA-mutant HR+/HER2– after AI, Capivasertib + fulvestrant improves outcomes in tumors with PI3K/AKT/PTEN alterations, Everolimus + exemestane restores endocrine sensitivity in some AI-resistant HR+, Adjuvant abemaciclib for high-risk node-positive HR+/HER2– improves IDFS when added to endocrine therapy (strict eligibility), PARP inhibitors (olaparib/talazoparib) for gBRCA/PALB2: adjuvant (select high-risk HER2–) and metastatic, Later-line ADCs in HR+/HER2–: sacituzumab govitecan after endocrine + targeted therapies, HER2 sequence (metastatic): taxane + trastuzumab/pertuzumab → trastuzumab deruxtecan (T-DXd) → tucatinib + trastuzumab + capecitabine (brain-active) → other TKIs (neratinib/lapatinib) case-by-case, Residual disease after neoadjuvant HER2 therapy: switch to adjuvant T-DM1 to reduce recurrence risk, Extended adjuvant neratinib for high-risk HR+/HER2+ after trastuzumab (diarrhea prophylaxis mandatory) — center-specific use, T-DXd active in HER2-low (IHC 1+ or 2+/ISH–) metastatic after prior lines — emphasize ILD vigilance and early drug holds if symptomatic, Pembrolizumab for high-risk early TNBC (neoadjuvant + adjuvant) improves pCR/EFS, Sacituzumab govitecan, gBRCA TNBC benefits from PARP inhibitors (metastatic) and adjuvant olaparib (select early), Platinum agents, HER2+ CNS disease: tucatinib-based regimens, Oligometastatic scenarios (all subtypes): consider SBRT or surgery after systemic response in tumor board, Rare MSI-H/TMB-H/NTRK fusion.
The established options for Breast Invasive Ductal Carcinoma (IDC) — ask which apply to your case. Investigational options appear in the compounds list above.
Open recruiting trials (18)
- NCT07195344 · Phase 4 — Study Aiming to Compare the Plasma Exposure of the Payload (Free-DXd) in Patients Treated by T-DXd for Locally Advanced or Metastatic Breast Cancer According to Their BMI. (France)
- NCT05827081 · Phase 3 — Phase IIIb Study of Ribociclib + ET in Early Breast Cancer (United States)
- NCT03755739 · Phase 2 / Phase 3 — Trans-Artery/Intra-Tumor Infusion of Checkpoint Inhibitors Plus Chemodrug for Immunotherapy of Advanced Solid Tumors (China)
- NCT04547907 · Phase 3 — A Comparison of Nab-PHP and TCbHP Efficacy in Neoadjuvant Therapy for HER2-positive Early Breast Cancer (China)
- NCT06860529 · Phase 2 — Serplulimab Combined With Chemotherapy for Early-stage HR+/HER2- Breast Cancer (China)
- NCT05035836 · Phase 2 — A Phase 2 Single-Arm Open-Label Pilot Trial Evaluating Zanidatamab (ZW25) in Patients With Early Stage HER2/Neu Positive (HER2+) Breast Cancer (BC) (United States)
- NCT01174121 · Phase 2 — Immunotherapy Using Tumor Infiltrating Lymphocytes for Patients With Metastatic Cancer (United States)
- NCT06169072 · Phase 2 — Sentinel Lymph Node Localisation With an Ultra-low Dose of Magtrace in Breast Cancer Patients (Sweden)
- NCT06625775 · Phase 1 — Open-Label Study of BBO-10203 in Subjects With Advanced Solid Tumors (United States)
- NCT07222267 · Phase 1 — An Investigational Study of BG-75202 Alone and in Combination With Other Therapeutic Agents in Adults With Advanced Solid Tumors (United States)
- NCT03823144 — Intravital Microscopy in Human Solid Tumors (United States)
- NCT07546331 — Novel Body Composition Measurements in Association With Outcomes of Breast Reconstruction Reconstruction (United States)
- NCT06703567 — IMproving PAtient UndeRstanding of GEP TEst Results: Phase 4 (Italy)
- NCT07448467 — Investigation of the Effectiveness of Progressive Resistance Exercise Training in the Management of Lymphedema. (Turkey (Türkiye))
- NCT07228000 — Bundled Cancer Screening and Genetic Services Navigation (United States)
- NCT06068257 — Tumor-Derived FGF19 (United States)
- NCT05178498 — Impact of Dietary Inflammatory Potential on Breast Cancer Risk (United States)
- NCT07206121 — Feasibility Study for the SIRA-1000, SIRA® RFA Electrosurgical Device as an Adjunct to Breast Conserving Surgery (United States)
Most-relevant first: trials that name Breast Invasive Ductal Carcinoma (IDC), then broader trials you may still qualify for. Eligibility is decided by each trial's team — bring these NCT numbers to your appointment.
Financial help to look into
- PAN Foundation — Copay assistance funds by diagnosis (funds open and close as money allows). https://www.panfoundation.org/
- HealthWell Foundation — Copay and premium assistance funds by disease. https://www.healthwellfoundation.org/
- CancerCare — financial assistance — Limited grants plus free financial counseling. https://www.cancercare.org/financial
- Family Reach — Help with everyday living costs (rent, transport, food) during treatment. https://familyreach.org/
- NeedyMeds — Searchable directory of drug patient-assistance and discount programs. https://www.needymeds.org/
For each medicine above, search manufacturer and nonprofit programs at medicineassistancetool.org.
Questions to ask your oncologist
- Has my tumor been tested for ER (estrogen receptor), and would the result open up targeted treatments or trials?
- Has my tumor been tested for PR (progesterone receptor), and would the result open up targeted treatments or trials?
- Has my tumor been tested for HER2 (ERBB2) amplification/overexpression, and would the result open up targeted treatments or trials?
- Of the open trials I found (for example NCT07195344), am I eligible for any — here or at a larger cancer center?
- Which subtype do I have (luminal A/B, HER2+, TNBC) and what is our best curative plan?
- Do I need neoadjuvant therapy to increase breast conservation and tailor adjuvant options by response (pCR vs residual)?
- Will a genomic assay (e.g., Oncotype DX) change whether I need chemotherapy?
- Am I a candidate for lumpectomy with oncoplastic techniques, or is mastectomy preferable?
- Do I qualify for Z0011-type omission of axillary dissection or targeted axillary dissection after neoadjuvant therapy?
- What radiation fields (breast/chest wall, nodes) and schedule (hypofractionation, 5-fraction, boost) fit my case?
- How does reconstruction timing interact with radiation to optimize outcomes?
- Am I eligible for CDK4/6, PI3K/AKT/mTOR, PARP inhibitors, or ADCs (T-DXd, sacituzumab)?
- Should we test for ESR1/PIK3CA/AKT1/PTEN through ctDNA now or at progression to direct targeted therapy?
- What is our cardiac monitoring plan on HER2 therapy or anthracyclines?
- How will we detect and manage ILD risk on T-DXd and stomatitis on everolimus?
- What’s the plan for diarrhea on abemaciclib/capecitabine and hyperglycemia/rash on alpelisib/capivasertib?
- Should I pursue fertility preservation before chemo, and how would ovarian suppression fit in?
- Can I pause endocrine therapy in the future for pregnancy under supervision?
- How will we prevent lymphedema and bone loss, and what are my DEXA and bone-agent plans?
- Which clinical trials fit my biomarkers (ESR1, PIK3CA, BRCA/PALB2, HER2-low)?
- What is our imaging and clinic follow-up cadence during and after treatment?
- What support do you offer for fatigue, cognitive changes, sexual health, and return to work?