Angiolymphatic Invasion Presence
Comments
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Here is the URL to the full article. http://onlinelibrary.wiley.com/doi/10.1002/cncr.26711/pdf
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You can simply ask for it at your local library and they can get it for you for FREE! I do that all the time!
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@yorkiemom... the oncology/clinical trial nurses said that it was, probably, "infected" by its proximity to the tumor. They said that, once the tumor grows over 2cms in size, it begins "sloughing" off tumor cells, which can - eventually - create satellite tumors in the breast and/or make their way into the lymph nodes. That's why chemotherapy is recommended (at least by my cancer centre) for node-negative patients that have tumors larger than 2cms... they know the tumor is "sloughing" even though the travelling cells may not have lodged anywhere else in the breast to create a new tumor or made their way to the lymphatic system.
In my case, apparently, the proximity of the sentinel node to the tumor was the key: it either became "infected" by the "cell-sloughing" or it became "engulfed" by the spreading tumor (i.e., tissue spread). Either way, the sentinel node tested positive for cancer cells. Further sampling (another 6-7 nodes) showed no further evidence of tumor metastasis, leaving my axillary nodes "clean".
The positive node is still problematic in that it may not have held on to all the cancerous cells, and one- or two (or more) may have escaped from it and into the lymphatic system (which is another reason why my cancer centre, strongly, recommended chemotherapy for me), but not as problematic as LVI and positive axillary lymph nodes.
As the nurse said, "... the red- and blue flashing lights, and screaming sirens can be - possibly - downgraded to just red flashing lights ..." I'm still at risk for recurrence, but I am less at risk than I could have been. I'm trying not to read too much into it. -
I have not read all the posts but here is some of my thoughts bases on some of the things I read about LVI/nodal invasion. In the past they put a lot more weight on LVI but overtime they saw that nodal invasion was a more accurate predictor of mets. Typically you don't have LVI without nodal invasion but it happens.
Anyway my thoughts are just because some cells slough off into the blood stream doesn't mean they are "mature" enough to develop. Where as once they have made their was to the nodes they might be a bit more "mature." Again just my thoughts. To be honest I don't even thing the medical community really knows. There are just so many things that factor into breast cancer, and many they don't even know about yet.
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Lago, I am one of the rare ones. No LVI found but 2 sentinel nodes with micromets. My tumor was only 1.3 cm. but obviously some was taken during the biopsy. I've read here that the biopsy itself can spread the cells. Wonder if that could have happened to me. It was 1 1/2 months from my biopsy to surgery.
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Yorkie I mean the other way around. Typically if you have LVI you have node invasion but not all node invasion has LVI. At least that's how I understood it. I might be wrong.
Biopsy might lose some cells along the tract that's why they take it out but it doesn't "spread" it. Be careful there is lots of convincing mis-information out there.Your biopsy didn't cause the lymph invasion.
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Thanks lago! Still curious as to how a pretty small tumor got from behind my nipple to the sentinel nodes without LVI. I think I am missing something.
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I'm pretty curious how my very fast growing HER2+, grade 3, High MIB rate tumor didn't go to my nodes or LVI!? My BS thought for sure I would at least have micromets.
Like I said there is so much they don't know about our diseases… breast cancer being more than one disease. Bottom line we are alive and doing well.
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Absolutely!
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VORACIOUSREADER ---- THANK YOU, THANK YOU, THANK YOU!!!!
You rock. That was my question, and you even posted the specific and latest Onc.journals (you must have $$) that specifically state why it's not in staging criteria --- but clearly SHOULD be.
As much a layperson that I am, I like it when I'm figuring out what's missing in the debate.
Thanks again,
Hugs
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My next question is where should "Angiolymphatic Invasion Present" fall in Staging Criteria?
Let me think, hmm, if: "LVI was strongly associated with both breast cancer-specific survival (BCSS) and distant metastasis-free survival (DMFS)" then definitely a stage IVa. Yes I know there isn't a stage IVa but I'm just trying to appease those who think you need a "lesion" to qualify for stage IV. How about Lesion and Mets = Stage IVb.
Nuff said...
Hugs
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are you saying that LVI should make you IVa? I had LVI with involvement in the skin lymphatics and I still can't get the docs to say IIIB.
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mammalou, did you read the Oncology reports posted above by Voracious Reader?
If LVI is the significant prognosticator of breast cancer and metastistic disease survival don't you think it should be in IV?
Stage IIIb and IIIc is not systemic but local. My Onc conceded to me that heavy angiolymphatic invasion is systemic cancer. I'm sure there may be degrees of LVI and in some cases they are minimal so maybe should be stage III.I can't speak to your path report and reference to skin.
I think it will be a factor in staging and it just takes time. I ditch docs who show little thought leadership. I want a leader in my team.
Hugs
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I would like to bump this up. My first biopsy states focal LVI. I have Invasive Mammary cancer with ductal and lobular features
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Should have added both breast, found that out after I opted for double mastectomy. Anyone know more about Angiolymphatic
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