Vascular Invasion... WHAT does that REALLY mean?

Options
Nicole112
Nicole112 Member Posts: 327
edited June 2014 in Stage I Breast Cancer

Hi ladies,

I know I am a few years out of treatment and diagnosis... so perhaps my head is out of the fog and I am starting to listen better... I was going in for my routine 3 month check up (Yes, I am still on the 3 month schedule because I get Lurpon shot to keep me in menopause)... and I was asking the NP why I was still getting Zometa infusions for early BC. There was a study showing there was not much benefit for those taking this preventative treatment. She said, in my case, there are benefits... she also reminded me of something that I must have checked into the back of my mind... this "vascular invasion" thing.

Anyone else had this on their path report? I hate to "google" anything, I would rather ask you ladies.

Also, I find that the more time passes, the more questions I have!

Thanks!

Nicole

· Share on FacebookShare on Twitter
«1

Comments

  • lago
    lago Member Posts: 17,186
    edited January 2011

    You might want to check out this thread:

    LVI positive 
    http://community.breastcancer.org/forum/67/topic/759729

    · Share on FacebookShare on Twitter
  • Nicole112
    Nicole112 Member Posts: 327
    edited January 2011

    Thanks Lago! I was reading that thread and now I think I am more confused than ever! It appears there is no "clear cut" answers behind this, are there?

    Also, I was reading your story and grateful to hear that in all your bad news, you got so much good news!

    Another question, I failt ounderstand, my first surgery 1.7 cm, had to have reexision where there was add'l 1.2 cm removed... cleared the margins... but barely... then they threw me into chemo... no mastectomy. They staged me as 1B, they never added the 2 tumorsizes together... but I have read on these boards that sometimes they do?!? Urrghh, this whole thing gets me so flustered!

    Do you have any insight on this?

    Thanks!

    Nicole

    · Share on FacebookShare on Twitter
  • kira1234
    kira1234 Member Posts: 3,091
    edited January 2011

    Nicole, At the reexision was more tumor found, or just getting the magins right. In my case the reexision was just to get better margins, actually in my case wide margins. I'm also a stage 1b, and my BS easily took that much tissue if not more. He removed about a tennis ball size from me.

    Just to add I didn't have vascular invasion involved, Ibut i think it means there is blood being supplied to the tumor.

    · Share on FacebookShare on Twitter
  • Nicole112
    Nicole112 Member Posts: 327
    edited January 2011

    Good morning Kira,

    The first surgery did not get it all, so my understanding is, there was 1.2 more found and barely cleared the acceptable margins... now I am a bit unclear if that was more tumor, or the add'l area for the reexision... why am I being flooded with questions this far out from diagnosis... I wish the human brain could allow us to "forget" woudln't that be nice :)

    · Share on FacebookShare on Twitter
  • sheila888
    sheila888 Member Posts: 25,634
    edited January 2011

    (((Nicole))) 

    · Share on FacebookShare on Twitter
  • bdavis
    bdavis Member Posts: 6,201
    edited January 2011

    hmmm... Vascular invasion means blood supply, so I would definitely follow up since maybe you would be a good candidate for something more radical. I know people who have had re-excisions and ultimately have a mastectomy just to be sure. The clear margin thing is important... cancer can spread through the tissue without clear margins and thru the blood supply (vascularr), as well as lymph nodes.

    · Share on FacebookShare on Twitter
  • in_cognito
    in_cognito Member Posts: 429
    edited January 2011

    Hi Nicole -

    They are not supposed to add the tumors together - staging is based on the largest tumor size. 

    There was a research study report I was reading that said that we should move towards adding the tumors up in node positive women, but since I was node negative I did not save the report. 

    I choose to keep my head buried in the sand as I had multifocal tumors.  Laughing

    I had a lumpectomy and re-excision and went back for a BMX after chemo. 

    · Share on FacebookShare on Twitter
  • Nicole112
    Nicole112 Member Posts: 327
    edited January 2011

    Sheila, THANK YOU FOR THE HUG, it was much needed today!

    Thank you bdavis, I have been on the fence for a mastectomy...

    In-cognito, thank you for your knoweldge! I will live with the fact the "experts",doctors told me I am Stage 1B, what the heck is the B anyway???

     I am in the bay area, too! Livermore to be exact. Perhaps we are neighbors!?!

    Have a great Sunday ladies!

    xoxo

    Nicole

    · Share on FacebookShare on Twitter
  • kira1234
    kira1234 Member Posts: 3,091
    edited January 2011

    Nicole 1b is 6mm-1cm. Mine was 6mm or .6cm

    · Share on FacebookShare on Twitter
  • lago
    lago Member Posts: 17,186
    edited January 2011

    Nicole It sounds to me that they did get all your tumor the first time but the magins were not clear or were too close. I too had a close margin (.75cm from posterior margin) but they still considered that clear enough for me and did not go back in.

    My tumor was 5.5cm but that was just the invasive part. Less than 25% of it was DCIS but they don't include that in the measurement. I have no idea large that part was. It was only the 1 tumor in that breast and a small amount of LCIS in the other.

    And from what I have read you are correct. The information regarding LVI is all over the place. They tend to put much more emphasis on node status. No one ever even discussed LVI with me. I just noticed it on my path report and started researching… only to find like you it might not mean anything.

    For staging information check here: 
    http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient/page2

    · Share on FacebookShare on Twitter
  • kira1234
    kira1234 Member Posts: 3,091
    edited January 2011

    lago it is all so comfusing to me. I am 1b, but my tumor was .6cm and no invasion anywhere else. My lymph node was clear as well. I just know my BS said I was a 1b because it was .6cm, and it would have been 1a at .5com.

    · Share on FacebookShare on Twitter
  • in_cognito
    in_cognito Member Posts: 429
    edited January 2011

    Nicole - I am in San Leandro - I go to Valley Oncology in Pleasanton.  I have a 10 month old and 3 year old - I saw in your profile that you had a little baby when you were diagnosed too!  Maybe we can do a playdate one day at Super Franks!!!

    · Share on FacebookShare on Twitter
  • bdavis
    bdavis Member Posts: 6,201
    edited January 2011

    I am 1b and had 1.9cm... stage 1 up to 2cm.... the "b" part is due to my micromet in node... thats what my bs says... my onc says stage II... at the end of the day, same thing for me, no matter what they call it.

    · Share on FacebookShare on Twitter
  • Nicole112
    Nicole112 Member Posts: 327
    edited January 2011

    In cognito, I was at Super Franks yesterday... FUNNY... did you have Dr Patel for radiation? Dr Sherman out of John Muir is my onc... small world... my little one is 3 1/2 years old now. We can do a playdate, this would be great!

    bdavis, thanks for your info... I am still a bit confused about my "b" because I never heard words like micromet in node, etc... only 1.7 cm plus re-excision to clear the margins... and vascular invasion... "why do they have to use the word invasion, sounds so harsh!"... perhaps the vascular part is the reason for my "b"... anyway, much like you, it really means nothing, other than I attacked it with all I had to give... and I continue to do my maintenance so what else can we do?

    · Share on FacebookShare on Twitter
  • bdavis
    bdavis Member Posts: 6,201
    edited January 2011

    Perhaps... If you read the staging breakdown, you are stage 1 for size of tumor... something is making you "b"... and could possibly be the vascular part, while mine was the node part.

    · Share on FacebookShare on Twitter
  • LRM216
    LRM216 Member Posts: 2,115
    edited January 2011

    Here is the AJCC Staging system for Breast Cancer (but it's all in millimeters so you will have to convert).

    http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional/page3

    edited to add:  10 millimeters equals 1 centimeter

    · Share on FacebookShare on Twitter
  • kira1234
    kira1234 Member Posts: 3,091
    edited January 2011

    LRM216 You have answered my question. Thanks so much for the help.

    · Share on FacebookShare on Twitter
  • LRM216
    LRM216 Member Posts: 2,115
    edited January 2011

    Kira:

    Glad to have been able to help.  Wishing you the best,

    Linda

    · Share on FacebookShare on Twitter
  • marbletop
    marbletop Member Posts: 26
    edited January 2011

    Vascular invasion, I believe means if cancer cells got into the blood vessels of the breast area. It is one of the tests that are on your pathology report. ,I believe this issomething your medical oncologist will take into account when he or she reads report to decide the best treatment for your case.

    · Share on FacebookShare on Twitter
  • Shrek4
    Shrek4 Member Posts: 1,822
    edited January 2011

    Cellist is right. Lymph/vascular invasion means the cancer cells have broken the blood vessel barrier and are circulating in the blood, making it more probably to get metastasis to another organ of your body. It has nothing to do with the blood supply of the tumor.

    If the lymph/vascular invasion is present, the treatment is more aggressive, because it means there is a high probability that the cancer has moved to another organ and might start metastasizing.

    You can have no node involvement but have LVI, or you can have positive nodes and NOT have LVI (that was my case and that is why I didn't have radiation even if I was IIb with the sentinel lymph node with a 3mm tumor in it).

    Here's a much easier to understand staging (look towards the end of the page):

     http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-staging

    · Share on FacebookShare on Twitter
  • zap
    zap Member Posts: 2,017
    edited January 2011

    ........ Lymph/vascular invasion means the cancer cells have broken the blood vessel barrier and are circulating in the blood, making it more probably to get metastasis to another organ of your body. It has nothing to do with the blood supply of the tumor......above post.

    This above statement-like post   could be positively terrifying to anyone with vascular invasion on their path report.   My oncologist used the words (more possible) and not more probable. BIG DIFFERENCE!  He also said that the cancer cells could be in the blood supply within the breast and not necessarily loose canons outside of the breast;  thus radiation on the infected breast  with systemic chemo in the unhappy event the rogue cells have traveled to distant places.  Knowledge is power but let's be careful what words we use to share knowledge.

    · Share on FacebookShare on Twitter
  • spendygirl
    spendygirl Member Posts: 231
    edited January 2011

    I recently re-read my path report and saw that it states lymphovascular space invasion is identified.  So I'm very interested in what you all have to say.  Thank you for all the info.

    Hugs, Tracye

    · Share on FacebookShare on Twitter
  • webu
    webu Member Posts: 87
    edited January 2011

    I've asked three oncs about LVI because it was on my lab report, too, and they all said it wasn't something to worry about (easy for them to say). They all said  that it wouldn't make any difference to my treatment if it was present or not; that the important factors in deciding on treatment were tumor grade and my HER+ status. Once did say he would prefer not to see LVI present, but by itself it is not an indication that the cancer is more likely to spread. 

    · Share on FacebookShare on Twitter
  • mks16
    mks16 Member Posts: 415
    edited January 2011

    I finally found a straight forward and simple enough explanation of what LVI really means.

    http://www.dslrf.org/breastcancer/content.asp?CATID=28&L2=3&L3=7&L4=0&PID=&sid=132&cid=1104

    · Share on FacebookShare on Twitter
  • Annie62
    Annie62 Member Posts: 1,081
    edited January 2011

    Hi all,

    My original path report in 12/04 said I had vascular invasion. I had postivie lymph nodes. I never got a mestastisis. My recurrence also has not shown mets. So I don't want people to think that because they have vascular invasion you will certainly get mets.

    Annie

    · Share on FacebookShare on Twitter
  • mks16
    mks16 Member Posts: 415
    edited January 2011

    Thank you Annie, that helps set my mind at ease:)

     My biopsy report said no LVI observed, but the path report I received yesterday found micromets in one sentinel node and LVI is also present.

    It does make sense to have LVI present if there's cancer cells in nodes, how else would they get there..

    All the best to you!

    · Share on FacebookShare on Twitter
  • barbe1958
    barbe1958 Member Posts: 19,757
    edited January 2011

    mks, the cancer cells get to the lymph node through the lymphatic system, not necessarily the blood stream. That's why it's important to know both issues.

    Makes sense, all above, so why then was the MRI tech for me jumping around and clapping his hands and saying "vascular invasion" when I had just been diagnosed? He wouldn't know what was happening in my breast at that point...would he? Just as well I took them off!

    · Share on FacebookShare on Twitter
  • mks16
    mks16 Member Posts: 415
    edited January 2011

    I agree barbe, however my path report reads like this:

     Lymphatic or Vascular Invasion:

    •  present

    It seems worded like it's either/or, and although both might be true, I will go with lymphatic invasion, for the peace of mind:)

    As for the MRI, maybe he saw that the tumor already created its own blood vessels? 

    · Share on FacebookShare on Twitter
  • barbe1958
    barbe1958 Member Posts: 19,757
    edited January 2011

    That's what I thought, about the tumour creating it's own blood vessels, but others after me said it had nothing to do with that, so now I'm confused.....what's new?

    · Share on FacebookShare on Twitter
  • mks16
    mks16 Member Posts: 415
    edited January 2011

    Barbe, did you check out this link? It explains LVI so that it makes sense... and it makes both theories plausible.

     I have trouble posting a link through Firefox, so you'll have to copy/paste:

    http://www.dslrf.org/breastcancer/content.asp?CATID=28&L2=3&L3=7&L4=0&PID=&sid=132&cid=1104 

    · Share on FacebookShare on Twitter

Categories