Should I be freaking out re: lymphovascular invasion?

DebRox

My path indicated lymphovascular invasion in addition to perineural invasion.  My sentinel node was clear.

Other negative items on my path ki-67 50%, grade 3 and larger tumor than anticipated by almost 1 cm.  I am premenopausal and 46 years old.

The lymphvascular invasion has me extremely worried about mets.  I don't really think I have signs of mets but how would I know and what would I look for.  Sorry is a dumb question. But I have a cough, but I was sick in January with bronchitis and March with a viral cough (my husband had it too).  Sometimes my hip hurts, but cannot tell if it is muscle or bone,  I did injure the muscle surrounding my hip some years ago.  I get headaches at least once a week, but I am sure due to stress.  All this invasion has me freaked out! 

What looked like a simple surgery going in, has become a nightmare!

Should I push for a CT or PET scan?  Which one is better?  Or am merely freaking out?

mdg

I had angiolymphatic invasion present and you can see my stats below.  Because I was stage 1 they would not do scans.  It sucks.  I opted for chemo to be on the safe side and finish next week.  We have similar stats.......I too am grade 2 ER/PR+.    I saw 2 different med oncs.  Based on my oncotype 17 one said no chemo.  The other said I would benefit potentially from chemo.  I am 45 and have a 4 year old son so I chose chemo.  My compromise was using cold caps to keep my hair.  One chemo left and I still have my hair though there has been a little thinning.  No one can tell but me though.  To be quite honest I did not read anything but negative things about angiolymphatic invasion.  It scared me too....that's why I did chemo in case.  I would discuss your concern with you med onc.  I am also premenopausal...... Good luck.  Sorry that you have to go through this too.  Hugs!

Lee64

My path report also said lymph-vascular invasion present as well as perineural tumor invasion and extracapsular extension into adjacent soft tissue.  Sounds really bad but my Onc never mentioned it and I didn't have my path report the first time I met with her. I have been looking on these boards for any mention of these findings and what they mean, how serious or not, and I find very little information. Surely we can't be the only ones. The gals who write here are so well informed I am sure we will be hearing from them soon, at least I hope. I would really like to have a little information before I bring this up to my Onc so I have some idea of what questions to ask. Thanks for any help on this subject.

Lee64

I forgot to mention that I had a PET scan and it came back negative. I would also like to know what the Ki-67 test is.

sweetbean

DebRox,

Ask for a CT scan, if only for your peace of mind.  I am sure it will come back negative and then you will feel better.   

Beeb75

Ki-67 is a measure of how many of the cells are actually dividing -- it indicates how fast the tumor is growing. Under 10 is low (and good), 10-20 is intermediate. 20 or higher is considered high. Mine was 20, they did the test on my biopsy sample. 

I also had lymphovascular invasion (I also had an involved node.) LVI isn't a make-or-break factor in and of itself, but it's one of the risk factors they look at when considering chemo.  

DebRox, it's very unlikely you have mets (though I was convinced I had them too upon initial dx.) The more probable worry is that there are loose cancer cells floating around in your body. You have a number of factors that might lead an oncologist to recommend chemo (pre-menopausal, high Ki-67, grade 3.) The job of chemo is to get rid of those cells and if they are fast-growing, they tend to respond better to chemo.

They are probably doing an Oncotype on your tumor which will give you more info. 

Lynn18

My path report stated "vascular space invasion present".  This was after surgery and neoadjuvant chemo. Neither my surgeon or onc thought it was important.  My onc said that it was something they would look at if someone had a small tumor, to decide on whether that person would benefit from chemotherapy.  It is something that has always confused me.

rumoret

I had lymphvascular invasion too. I heard Doctor Love explain it like cars lining up in the exit to the freeway. It is just another reason chemo is offerred.

Hugs,

Terry

suzieq60

I found this for you and following it is link to an article about it 

Lymphovascular Invasion

Breast cancers have a blood supply like normal tissue and organs. Tumors also have lymphatic channels running through them, which serve as a circulatory system in the body for tissue fluid and proteins separate from the blood circulation. If cancer cells under the microscope appear to invade into the blood vessels or lymphatic channels of the tumor, the possibility that cancer cells have spread to the lymph nodes or other areas in the body increases. This is called lymphovascular invasion or LVI.

 http://www.sciencedaily.com/releases/2009/05/090513204152.htm

Hope this helps

justagirl

Have any of you had a MRI to see if there are any breast cancer tumors elsewhere in your body?

I am freaked out.  I had a DM, chemo and radiation and am on Femara but still wonder daily if there is some big bad cancer cell lurking in my body.  My tumor was grade 3,invasive and aggressive with some dead cancer cells which means it's really aggressive and it was  lying right on my rib and sternum so the doctor got just the minimum of a clear margin 0.5mm when she did the lumpectomy before my DM.  Path from masectomy on the lumpectomy side came back clear.

It's just too much to sit and wait.

I'm afraid to be happy and think BC is behind me - it's like it's lurking in the shadows.  Am going to ask my GP for an MRI or PET scan or something to check my whole body.  I don't feel like anything is wrong but then I felt fine when I found the BC tumor 3 months after a clear mammogram and it was like 1.2 cm.

pumpkinweed

Hi Justagirl,

I was diagnosed 5 years ago with a cancer similar to yours plus LVI, and I am still doing great!  I did have a CT scan and bone scan at dx, but my tumor was small 0.9 cm and the likelihood of other cancers showing up elsewhere at that point was slim.  I'm not sure about an MRI, but CT scans can only pick up tumors 1 cm or larger.  My onc does not give scans because data show there is no impact on survival if a recurrence is caught earlier.  So, the philosophy is that tests just increase anxiety.  I struggled with this mindset, but now I agree with it.  I want to live cancer free, or at least believing I'm cancer free, for as long as possible.  If there is something lurking, what's the point in knowing now if it won't make a difference?   We've all been where you are now, and it definitely is the hardest part of BC -trying to manage the fear of recurrence.  It is a process that I got through by faith.  I am walking in faith that I am cured, though I still struggle every now and then with the fear.   I understand that the number of days I have on earth is not my business, but my business is to live every day fully.  Know that you are not alone, there are lots of people just like you doing great many years later.  Hope this helps...

www.hisfaceinmyjourney.blogspot.com

justagirl

pumpkinweed,

Thank you for your words.  Unfortunately for me, right now, having an MRI, which I would prefer over a CT would make me anxious to have it, but better afterward.  Right now I just can't get rid of the feeling that if I get too happy and readjusted to my life, Breast Cancer will up and smack me back down again......

I am happy your faith is bringing you through all of this. I just have a difficult time in 'believing' and have been that way ever since my mom died when I was 10.

pumpkinweed

Hi justagirl,

I am so sorry you lost your mom...  I can understand that it has impacted your faith.  Cancer forced me to deal with a lot of inner wounds from my past, and I experienced tremendous inner healing as well as physical healing.  So, please know there is a lot of hope for brighter days.  I do understand the feeling you described, I remember having it to.  Sometimes I allow myself to imagine the worst, thinking that it will somehow prepare me if it actually happens...  but the reality is that such thoughts just feed the fear and give it power.   I've worked really hard to NOT allow BC to have power over me, and most of the time, I am victorious.  So, it is possible to live a life of freedom from cancer.   You have a lot of life to live.  You do not have to live in the shadow of death.  Your stats are good...no nodes and a small tumor.  You caught it early and your prognosis is excellent!   There is much hope!  I will believe for you!!!!! 

http//hisfaceinmyjourney.blogspot.com

 

pumpkinweed

And justagirl, I forgot to mention the downside of having a scan at this point...  sometimes things show up that are not cancer, but could be cancer.  This happened to a friend of mine in similar shoes.  She insisted on a scan and a small spot showed up on her liver that was inconclusive.  The doctor ordered another test 3 months later to see if it had changed.  It was an agonizing 3 months... the spot did not change and my friend vowed to never have another scan again...  Sometimes the things we think will bring us comfort actually cause more stress.  So, I urge you to think this through as you talk with your doctor.  (Cancer sucks.)

justagirl

thanks pumpkinweed.

Sagita

After my lumpectomy last april 03 with postive margins, had to go back for masectomy with my second operation with really close margins but negative. I was happy about the negative margins but the bad news always has to be the last to hear of course. My tumor end up with 6 cm compared to 3.9 cm with my prevoius operation and with lymphovascular invasion. My oncologist for  chemo & radiation are  highly recommending the both treatment. I am really sadden and feeling really down for few days but i am ok now. It's been 7 months dealing with the illness, why get afraid now. I will meet my Onc this tuesday ( Aug. 16) to sign the writen consent, check ups needed to get done and the scheduling. I did'nt realize that chemo will last me 6 months and radiation for 7 & 1/2 weeks! On top of all this i did a immediate recons after masectomy, my TE will be in my body for almost a year ? Will meet my PS on the 17th to find out what they say now that i will have chemo & rad.

I wonder how many of us here went on the same path i am in now. Mind sharing your experience? Thanks