Is there a test for vascular invasion?

Hi Gcpommom,

On my pathology report from the mastectomy, under the section called "Margins," mine says "Venous/lymphatic (Large/small vessel) Invasion (V/L) Present."  To be honest, I'm not exactly clear on what it means, specifically.  I mean I'm not sure whether it means I had both venous and lymphatic invasion present, or how they determine it. 

Do you have a copy of your pathology report?  I'm interested to see what information others might have on this; maybe someone else can clarify.   Great question!

My lumpectomy pathology report states "No vascular or lymphatic invasion."  I do not have any idea how they test it either, but I did read somewhere that the pathologist either sees capillaries coming out of the tumor.  I hope someone with a LOT more knowledge about this comes along to help you out with a much clearer reply.

Linda

My mastectomy pathology report states "no definitive lymphovascular invasion is seen."  Then the at the end of report for staging-MX is listed, when I look that up, says no evidence of distance metastases.  I think they just could not definitively rule it out, but highly unlikely.

Yeah, I don't understand it either.  My original biopsy stated that I did have LVI present, but then the mastectomy found no LVI present.  All the docs I've asked about it have said that it is impossible to look at every single part of a tumor, so in guessing about what was found on mine, the LVI must have been small and only in a small portion of the tumor (why it was seen in the biopsy tissue, but not in the mastectomy)  Still don't get it, though.

I think they can check it if there is a blood vascular invasion or not. I had mined checked after path was done just for whether or not there was a venus blood vascular invasion, nd they said there was no vascular invasion. In my path report, they also said there was no LVI but I had a tiny tiny spot in the sentinal lymph node.

I've been thinking about this issue, and wondering what implications it may have.  I think part of the confusion is the term "vascular," which technically includes both blood vessels AND lymph vessels.  Evidently, both are possible metastatic pathways but it's not so easy to understand and clarify the differences.  My personal conclusion is "... it's very complicated." LOL! 

Here's an article that may help (although on my first read, it's clear as mud!)

 -Source HERE

"In conclusion, we demonstrated that the described immunohistochemical technique made it possible to discriminate between BVI (blood vessel invasion) and LVI (lymph vessel invasion) in BC and enabled a more sensitive detection of LVI and BVI and a better assessment of the extent of both than on conventional HE stains. Furthermore, our data demonstrate that most (lympho)vascular invasion in BC is LVI and that lymph vessel tumour emboli are larger than blood vessel tumour emboli. This suggests that LVI and BVI are not just different routes of BC metastasis, but that both pathways are characterised by a different biology."

On the flip side, my path report says there is no evidence of vascular invasion.  However, 2/12 nodes were positive.

Mine was listed as "angiolymphatic" as well, which means "blood-lymph" !  I wrote a little bit above about my particular case.  There was evidence of vascular invasion "in a few small angiolymphatic spaces" listed under "vascular invasion/type" (this leads me to believe there are different types) and it was only found in the small sample they took the biopsy from.  The mastectomy DID NOT find any vascular invasion present.  I've asked each of my doctors a zillion times each, why it could be present in the small sample and not in the large sample, and the best understanding I can come up with is this:  the biopsy sample was small, so they were looking at a focused piece of tissue.  This found vascular invasion.  THe mastectomy sample was much larger, so they chose a couple of random pieces to focus on (slices that were stained and looked at under the microscope).  These pieces DID NOT have vascular invasion present.  My onc said that there is no way they could test every bit of the sample--they only look at so many slices, so in her opinion, my invasion must have been minimal and would have gone undetected if just the mastectomy was done, AND that this probably happens in many bc cases.  Aggressive cancers, especially, like to travel just like susie123 wrote about above.  And in aggressive tumors, they don't always wait till they are bigger to do so.  I hate thinking about all this.  But it is what it is.. . .