Lymphatic Invasion

desimone

Hi - I have been going over my pathology report I thought that lymphatic invasion was the result of 1 of my nodes being positive. I now know that is not the case and this has stressed me out. I was quite positive about the report as I go see my oncologist on Monday. But having read about lymphatic invasion I now am not so positive. I have a Grade 3 (4.4 cm) tumor and lymphatic invasion and now feel doomed.

Does anyone know about lymphatic invasion?

Thanks

Gully

Hi Desimone,

LVI means that the pathologist has seen cancer cells inside the blood vessels and/or in the lymphatic vessels. I had this as well. Try not to stress out too much about it. My MO said the invasion can lead to spread of the cancer cells though the blood or lymph but invasive cancer does that anyway. Mine was focal. There are several grades of LVI, focal (minimal, present and extensive) I have read somewhere that they may consider extensive LVI as equal to 1 positive node. You can see my dx below, I also had an intermediate oncotype dx of 19 so I chose to do chemo because of the LVI but the MO would have supported not doing it. He said the focal LVI may increase the odds of a local recurrance. But bottom line, there really is not that much info on LVI and what it means for prognosis. Good luck with your visit to your MO. It will get better, once you have a treatment plan in place. (((HUGS)))

Kicks

It is not at all unusual for lymph nodes to be positive - especially with some types of BC.  'Nodes' (lymph nodes) are part of the lymphatic system.  It does not mean you are 'doomed'!  (19 of my 19 removed lymph nodes were positive and I'm 4+ ys NED for Stage IIIc IBC.)  A lot also depends on the type of BC - all BC is not equal in how aggressive it is.

As you have an appt on Mon - WRITE DOWN all of your questions and take the list with you to be sure you ask all of them.  She/He is the one who can give you the answers for you or (if you are uncomfortable with her/him) get a second opinion.  Stay away from "Dr Google" til then and you are armed with more info.

Loriell

Hello,

I am new to this board and this is my first post. Your post caught my interest as I had multiple vascular invasion in my breast as well. I was and am still confused about this. There isn't much information about vascular invasion as opposed to lymph node. To me this was really the scariest part of my pathology report . Due to this I am having chemo and radiation. I also had a bilateral mastectomy.

Wish the was more information about vascular invasion.

desimone

Hi - I just had my first appointment with the oncologist and he said he was not surprised that I had lymphatic invasion as I had 1 node involved. I will start chemo on Jan 6 - 4 cycle (every 3 weeks) of Doxorubicin and Cyclophosphamide then 4 cycle (every week) of Paclitaxel then followed by radiation then Tamoxifen for 5 years or longer.

I would really appreciate any information on these types of chemo's?

pupmom

I am still very confused about something. I had 2 positive nodes, micromets, but no LVI. How can the cancer travel to the nodes without some LVI being present?

Kicks

desimone - Doxorubicin is Adriamycin and Cyclophosphamide is Cytoxan.  Paclitaxel is Taxol.

They are all commonly used with BC.  

 Adriamycin and Cytoxan is often seen written as A/C.  For me, A/C was easier by far than Taxol was but for many others it is the reverse.  I did 4 A/C 2 weeks apart neoadjuvant (before surgery) and 12 weekly Taxol adjuvant (after surgery).    With A/C, I was only mildly tired on days 3 and 4 but a nap helped - definately did not keep me from doing anything I wanted to do.  On A/C, I lost head hair, about 1/2 of eye lashes/brows and other body hair, lost all appetite, senses of taste and smell.  Neulasta is often/usually give the day after infusion to encourage white cell production.  It usually produces pain which OTC Claratin is supposed to help.  I did not have pain from it at all but, almost to minute, 2 hrs after injection I would go to sleep for 2 hrs and wake up fine.

Taxol was a different story!    I was completely and utterly EXHAUSTED the entire time - I existed either on the couch in front of the TV or in bed.  Sleep never came no matter how exhausted I was without sleep meds (which I had never before needed or used).  I was able to make it to each infusion but the IV benadryl would put me to sleep as soon as it was given but I would wake up about 20 mins before end of infusion.  My temperature has always been on the low side anyway,  but on Taxol it really dropped.  The good thing about Taxol was a week after last infusion, I started feeling better daily.  I also started rads a week after last Taxol and Femara (it was not yet available in its generic form, letrozole) a week into rads.

Very basic, 'nodes' (lymph nodes) can be thought of as the pumping 'stations' for the lymphatic system.

You should be given an 'Education Class'  at your Center with a Chemo RN privately before 1st Chemo when you will be given lots of info and can ask questions.

Remember - we are each unique so we 'react' differently.  Our Drs are each unique and have different ideas onTX plans.  My TX plan was different than most IBCers have - for me it was right on.

ziggypop

Hi laidies - here's an article that may be of some help (it's very short). http://www.dslrf.org/breastcancer/content.asp?CATID=28&L2=1&L3=6&PID=&sid=132&cid=1104

desimone - this diagnosis does not mean that you are doomed. It will help guide your treatment plan, it is likely that with one positive node and grade 3, they were likely to do chemo and with the lymphatic invasion they will be more likely to. Chemo is a systemic treatment. So for instance, I had a full body scan which didn't show any evidence that the cancer had metastasized to other areas of my body beyond the breast and axillary nodes. But there's a chance that there can be some cells that don't show up on the scan. That chance is greater if the cancer is found in the nodes or if there is lymphatic invasion (but the lymphatic invasion can be a small or larger factor). When the factors add up to a high enough risk that there are 'micromets' - then they give you chemo. That chemo is (I believe) just as effective regardless of whether you have lymphatic invasion or not. Chemo generally sucks, but it is doable & if you have to go through it, you will get a lot of really good advice and support on these threads.

lkc

Hi Desimone,

Let me clarify some confusion about LVI which is lymph and vascular invasion. Lymph nodes are all connected by " channels' witch also involves blood vessels.

A pathology report is dependant on the tissue submitted which may only may only report a node or portion node, not the connecting channels, etc.

Regardless of the report if there is reported lymph node involvement that means the BC has spread beyond the breast itself (which is basically the lymph systems job as a filtering system) Anyway, lymph node involvment that cranks up the recommended tx.) which I feel is a good thing in the end.

I was dxed over 8.5 yrs ago with 12 positive nodes and Her2 pos BC and I am well and living large.

I try to come here to offer support to the newly dxed when I can.

What I can say is for you all to come to these boards often for support and info. This will help you.

I wish you all a gentle journey on the road that no one wanted to go down.

kjsimpson

Take 'doomed' out of your vocabulary!  You are not 'doomed'.  You have cancer.  Cancer starts with 'can'!  You 'can' do this!! 

I have a very aggressive form of cancer.  Shortly after I was diagnosed, I was talking to a couple of friends about the diagnosis and mentioned that it is very aggressive.  One of my friends looked at me and smiled and said, "Kathryn, of course you have an aggressive form of cancer.  We would expect nothing less of your cells than to be aggressive.  But we know that your good cells are even more aggressive than your bad cells and you've got this!" 

If I can do this, so can you.  ;-)