Invasive Carcinoma of the Breast

Understanding your diagnosis, assessment, and treatment

By Graeme Millar, Lead Breast Surgeon – Otago Surgical Associates

Being told you have Invasive carcinoma of the breast can be overwhelming. Many patients describe the early weeks after diagnosis as confronting and emotionally exhausting. My role, and the role of the team at Otago Surgical Associates (OSA), is to guide you through this period with clarity, compassion, and carefully coordinated care, delivered locally here in Dunedin and Otago.

As a breast cancer surgeon, my day-to-day work focuses on assessing breast symptoms, confirming diagnoses, and guiding patients through their individual breast cancer journey—from those intense early months of investigation and treatment through to calmer years of follow-up and recovery.

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What is Invasive breast carcinoma?

Invasive breast carcinoma No special type (previously called Invasive Ductal carcinoma of the breast) is the most common type of invasive breast cancer. It begins in the milk ducts and has spread into the surrounding breast tissue.

Invasive breast cancer can appear as multiple different types with multiple different Tumour biology’s which often require different treatment plans and treatment sequencing to give the best results. Please note that time will be taken to explain these differences carefully and your own preferences and opinions will be an important part of any treatment plan

Unlike DCIS (pre-cancer), invasive ductal carcinoma has the ability to spread to nearby lymph nodes or, less commonly, elsewhere in the body. The good news is that most breast cancers are detected early, and modern treatment is highly effective and curative in the great majority of cases.

Treatment of Invasive Breast carcinoma

Treatment is individualised and depends on:

  • Tumour size and location

  • Lymph node involvement

  • Tumour biology

  • Your overall health and preferences

Surgery

Most patients will require surgery, which may involve:

  • Breast-conserving surgery (lumpectomy), or

  • Mastectomy, if recommended based on tumour features or personal preference

Assessment of lymph nodes is commonly performed using sentinel lymph node biopsy but may be a more involved axillary assessment if this is recommended. Please note there will be a careful explanation of why this is recommended.

  • Invasive Breast carcinoma may be identified through:

    • A breast lump you or your GP can feel

    • Changes seen on imaging such as mammography or ultrasound when investigating following detection of other symptoms such as a lump, skin changes or nipple inversion/changes

    • Breast Screen Aotearoa screening mammograms.

    Once cancer is suspected, further assessment is arranged promptly.

  • Your first appointment will take place at:

    • Suite 6, Marinoto Clinic, Dunedin, or

    • My private clinic at Balclutha Hospital, which I hold twice monthly

    At this visit, I will:

    • Take a detailed breast and general health history

    • Discuss any symptoms and how they developed

    • Review your family history of breast or ovarian cancer

    • Perform a chaperoned breast examination

    • Review all imaging and biopsy results with you

    After the examination, we take time to sit down and talk through what the diagnosis means and what happens next.

  • Before any surgery, it is important to fully understand the cancer. This may involve:

    • Additional breast imaging (such as MRI)

    • Assessment of lymph nodes with ultrasound

    • Review of biopsy results, including tumour biology (hormone receptors and HER2 status)

    Many of these further investigations are usually arranged locally through Pacific Radiology, allowing a complete diagnosis before treatment begins.

  • Breast cancer care is never delivered by one person alone. I work as part of a large multidisciplinary breast cancer team, including:

    • Radiologists

    • Pathologists

    • Medical oncologists

    • Radiation oncologists

    • Breast care nurses

    • Allied health professionals

    Your case is discussed at a multidisciplinary meeting, where all aspects of your diagnosis are reviewed and a coordinated treatment plan is agreed upon.

The breast cancer journey

The early months after an Invasive Breast carcinoma diagnosis are often the most intense. During this period, our team provides very hands-on care and support, helping you navigate appointments, treatment decisions, and recovery. Breast Care nurses such as Mary Grant our Breast Clinical Nurse Specialist at OSA is there to provide information support and guidance alongside myself.

As treatment is completed, care gradually transitions into structured follow-up, usually lasting five years or longer. These later years are often calmer, focusing on:

  • Monitoring recovery

  • Managing long-term effects

  • Providing reassurance

  • Supporting return to normal life

Wherever possible, follow-up is delivered locally in Otago, close to home.

Our approach at Otago Surgical Associates

At OSA, Invasive Breast carcinoma care is:

  • Local – delivered in Dunedin and Otago

  • Multidisciplinary – involving a full specialist team

  • Individualised – tailored to your diagnosis and circumstances

  • Supportive – recognising the emotional impact of cancer

If you have been referred with Invasive Breast carcinoma, my commitment is to provide clear information, thoughtful guidance, and consistent support, from diagnosis through treatment and into long-term follow-up—here in Otago, with a team you can trust.

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