Extensive LVI found on surgery pathology

Hybrids

Hi all,

I had my lumpectomy this past Wed and my pathology came back on Saturday (yesterday), but I haven't talked to my surgeon or oncologist yet. It showed my pathologist had concern that there weren't clear margins, my nodes were negative (they took 4) but I had extensive lymphovascular invasion. It listed many things from many different slices, but an example of what it showed for each slice is: INVASIVE MAMMARY CARCINOMA, NO SPECIAL TYPE (DUCTAL), MSBR GRADE 2, RESIDUAL DUCTAL CARCINOMA IN SITU, INTERMEDIATE AND HIGH GRADE, DUCTAL CARCINOMA IN SITU, etc.

I was originally diagnosed with triple positive so I had Neoadjuvent TCHP before surgery, with a plan of radiation after surgery, then 5 years tamoxifen and then 5 years of the post-menopausal drug. This pathology still shows triple positive, but it showed the HER2 was equivocal, so they did a DUAL ISH test and it said it was positive for amplicfication with a 3.3 ratio, ki-67 was 28% and ER & PR were both 87%, 2+.

I'm assuming at some point next week, either my surgeon or my MO will call me to speak with me, but I'm guessing they will want me to have further surgery since the pathologist stated she was concerned about the margins "... GIVEN THE DEGREE OF TRANSECTION OF INVASIVE TUMOR AND DUCTAL CARCINOMA IN SITU AT WHAT IS DESIGNATED AS THE SUPERIOR MARGIN IN THE LUMPECTOMY SPECIMEN, I DO HAVE SIGNIFICANT CONCERN THAT THIS ENTIRE SUPERIOR MARGIN MAY NOT HAVE BEEN CLEARED WITH THE ADDITIONAL PIECE OF TISSUE TAKEN AS DEEP." but I don't know what to expect regarding the finding of extensive LVI. Does that sometimes change the treatment plan or do they expect radiation & the anti-hormone drugs to take care of LVI?

Just trying to wrap my head around what I might be able to expect come next week. I was so excited to be done with chemo & surgery and now I'm a little bummed