Positive Nodes and No LVI - why?

pupmom
pupmom Member Posts: 5,068
edited June 2014 in Stage I Breast Cancer

I've wondered about since my dx. I have 2 positive nodes with micromets but no LVI. I have always wondered why cancer sometimes chooses to invade nodes but doesn't develop LVI and vice versa. Anybody know or is this just another cancer crap shoot situation?

Also, my question isn't limited to those with Stage I and II. I just didn't know where to put the topic, so I chose the forum reflecting my stage.

Thanks!

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2013

    yorkie - what surgery did you have?  It is possible that you had LVI but it was not noted on your path report, or not seen in the specific slides that were examined.  There is some thought that isolated tumor cells in the nodes arrive there because of the disturbance from biopsy - i.e., the node is doing its job by catching those cells.

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  • pupmom
    pupmom Member Posts: 5,068
    edited January 2013

    Special K, my path report after surgery says no LVI found. I have wondered about biopsy for some time. Two years before my cancer dx I was referred for a biopsy at exactly the same spot (surgeon who did my second biopsy verified this). That, first surgeon, found b9 results, so I moved on. I keep reading that biopsies can't spread cancer, but in my case it is highly suspicious for that. The two year time frame would have given the very slow growing cells time to invade and grow in the lymph nodes. It's very confusing.

    Another edit, sigh: I had a lumpectomy, but the surgeon said she got great margins and they examined the entire specimin. There was really no evidence of LVI.

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  • pupmom
    pupmom Member Posts: 5,068
    edited January 2013

    Kayb, in my case I suspect that I did have a malignancy, maybe DCIS at that time, but the surgeon didn't get the right sample. I think he got nearby good tissue. Just my musings, but to me things don't really add up.

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  • wildrumara
    wildrumara Member Posts: 450
    edited January 2013

    Yorkie -  I also had 2+ nodes, but no LVI.  I have read here on BCO and like Special K pointed out that it might not have been present on the particular slide that the pathologist was looking.  There are quite a few threads about this on BCO. 

    But, when looking at my path report, it says  "Immunohistochemistry for CD34 and D2-40 on part E fail to demonstrate any lymph-vascular invasion.   Part E on path report was my entire right breast.  Part E is then broke down into different sections and different slides (ie: nipple/areola, skin, the two masses I had, a few lymph nodes, etc... There were a total of 20 slides on part E.  According to what the pathologist dictated, the two tumors were on 5 slides.  I can only hope that he stained these five slides.  According to what he dictated, no LVI was present on these slides. I also thought there was a difference between LVI and positive nodes.  That LVI was more about the vascular system too??   Who knows? 

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2013

    I think if we understood more about how cancer moves through the body some of this would make sense but it seems that those cells are pretty sneaky and can move around sometimes through the lymph system, sometimes vascular.  Kind of the same situation with tiny tumors, positive nodes and distant mets as compared with large tumors, no nodes and no mets - there does not seem to be a hard set of rules!  Very frustrating!

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  • pupmom
    pupmom Member Posts: 5,068
    edited January 2013

    Wildrumara, LVI does have to do with the vascular system, not the nodes, if I read your post correctly. Don't know where your pathology report was done, but mine was at an NCI hospital. I will have to look more closely at the report to see how many slides were done, but I am quite confident that they looked at the entire area that was excised, even the good tissue. I see my MO in March and will ask her about all this.

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited January 2013

    LVI has to do with both lymph and vascular systems, which are separate and distinct.  Here is the word from this site:

    http://www.breastcancer.org/symptoms/diagnosis/ask_expert/2004_11/question_16

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