Lymphovascular invasion present?

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DXat32
DXat32 Member Posts: 29
edited June 2017 in HER2+ (Positive) Breast Cancer

Hi, everyone-I received a call from my bs that my re-excision surgery to get cleaner margins on Wednesday went well; they are negative now.  This is good news, I know.  However, it prompted me to look over my original pathology report (the one from my MX on June 18th), and after examining/analyzing it more, I noticed that it said "lymphovascular invasion: PRESENT".  Of course, I googled it, and it does not sound good.  I am shocked that when my bs called originally and said that I was Stage 1 with negative lymph nodes that this lymphovascular invasion was not brought up.  Perhaphs he wanted to spare telling me negative news and would just have my oncologist talk to me about when we meet in 2 weeks?

I am wondering if anyone else out there has/had lymphovascual invasion and if it in fact means that this may have metastisized into other areas of my body through the blood vessels.   Is it more related to us HER2+ gals? is there a test to check for this prior to starting chemo? I am just really confused! Any insight would be greatly appreciated.

Nichole

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  • Youngwithbc
    Youngwithbc Member Posts: 167
    edited July 2013

    Hi Nichole,

    I have LVI as well... and had the same reaction as you when I saw it on my path report. It also was something they likely weren't ever going to mention, but I happened to see it myself. Essentially, it is a risk factor... as are many things (Grade, age, etc.) and can influence treatment decisions. But it's not anything in and of itself to get worried over... just another "thing" to add to the list. Another trait of the cells.

    I remember reading this when I was doing research about it, so you might find it helpful:

    http://www.dslrf.org/breastcancer/content.asp?CATID=28&L2=1&L3=6&PID=&sid=132&cid=1104

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  • sciencegal
    sciencegal Member Posts: 1,120
    edited July 2013

    Nichole I had it too and also a 9 cm tumor with 3 of 4 nodes positive. We threw TCH neoadjuvant chemo at it and, with the herceptin, I had no tumor left at the time of mastectomy, in either the excised breast tissue or the 24 lymph nodes removed. No mets on the scans.



    I am now in radiation and hoping that there are no cells hiding out. I jsut wanted to let you know that you can become a "NED" even with that diagnosis.



    I wish you the best.

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  • gildedcage
    gildedcage Member Posts: 139
    edited July 2013

    Thank you for asking this question because I see the same thing on my pathology report. I'm waiting on the Oncotype test to see if chemo is recommended. I guess we've just got to wait and see. 

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  • Lenn13ka
    Lenn13ka Member Posts: 313
    edited July 2013

    I had extensive LVI. It wasn't in my original path so I started out stage 1 grade 1 but after my surgery I had a small 4mm macromet in sentinel node and became stage 2a and grade 2 . I read that if you have LVI and you tumor is in the right quadrant you have a very good chance of having a positive node. I, too, did lots if reading and it didn't sound good. But, after my Oncotype score if 17 and a second opinion from one of the best in the country I didn't do chemo. These docs felt radiation would take care of the LVI and chemo wouldn't do much for me with my Oncotype... So right on hormone treatment. It is one of those things they pay attention to but don 't put more weight on it.

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  • Lenn13ka
    Lenn13ka Member Posts: 313
    edited July 2013

    Ps my tumor was small .8 cm.

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  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited July 2013

    I also had LVI. Oncotype score of 19. I did not do chemo, only radiation. I know when I read my path report and did research, this part was extremely worrisome. My oncologist and radiation oncologist, however, are not overly concerned. I try not to dwell on it, but will admit that it weighs heavily on my mind. Still do not exactly understand how I can have LVI, yet clean nodes. I pray that this means my LVI was just starting and we caught it in time. Femara hopefully will get any stray cells that escaped. This is my story and I am sticking with it for peace of mind!

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  • monkeymom
    monkeymom Member Posts: 50
    edited July 2013

    I also have LVI but clean nodes. My BS said it means the cancer was "trying" to get to the nodes and had we waited even a few more weeks for surgery it "might" have gotten there. She feels she got everything with the BMX but I'm doing chemo because of the HER2 obviously.

    I googled LVI and it sounded scary so I asked my onc about it. He didn't seem overly concerned either- he said it may add a few points to my overall reoccurence risk but again very minimal. I don't know if he was just trying to keep me calm honestly:) 

    Neither doctor really highlighted the LVI until I asked...

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  • kathleen1966
    kathleen1966 Member Posts: 793
    edited July 2013

    I have read that LVI is the equivalent of one positive lymph node. I had this with my four positive nodes. Don't read to much about this, you will worry yourself endlessly. Anyone who has had an invasive cancer likely has microscopic cancer cells in their blood. The chemo is supposed to take care of this. LVI present increases the chances that positive lymph nodes will be found. You are fortunate to not have these!  I am coming up on three years since my diagnosis. I hope that is helpful. I know that three years sounds like a long time to the newbies, I enjoyed seeing it three years ago when I entered this site.  I also enjoyed seeing those three year NED-ers turn into four, five and six year survivors....You will see this too! 

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  • Gully
    Gully Member Posts: 268
    edited July 2013

    Thanks to monkeymom and kathleen: I have focal LVI with bilateral bc as you can see from my dx line. Node neg and oncotype of 19. I have done 3 rounds of TC, getting ready for round 4 on Tues the 9th. I have just been researching LVI and frankly it scared the shit out of me. My onc has not really mentioned it, but I have also read that it can be considered a pos node. Congrats on the three year survival so far. Hope you have many many more.

    Bayoubabe: I pray as well that they caught my LVI early because of neg nodes. But its still scary.Foot in Mouth

    My quesstion was should I do two more treatments of TC....will it make a difference at all? This is all such a crapshoot and very frustrating!!!!! Guess I will just have to figure out how to not dwell on it!

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  • sciencegal
    sciencegal Member Posts: 1,120
    edited July 2013

    Kathleen, thank you- this newbie really does apreciate your post, especially since you had a similar diagnosis to mine and were also a "big tumor gal".



    Thank you for the inspiration and congratulations!!!

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  • lkc
    lkc Member Posts: 1,203
    edited July 2013

    Hi Ladies. I had LVI,  12 positive nodes AND a stage IIIC her2 pos BC. That was over eight years ago.

    Now, I belly laugh every blessed day.

    You all will get through this and the fears will subside.

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  • Gully
    Gully Member Posts: 268
    edited July 2013

    Congrats, IKC that is so great! My MO went over my concerns yesterday. He said my election to have BMX and chemo TC  for four rounds, with an oncotype of 19 was an agresssive treatment for the position in the breasts of the  focal LVI, inner quadrant and node neg situation,  and with my tumor stats I have done what I can at this point. Now is the time to focus on my hormone therapy which may be more important for me. 

    Good luck to all, I am leaving my LVI worries behind me! It is what it is! Hughs to all.

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  • BayouBabe
    BayouBabe Member Posts: 2,221
    edited July 2013

    Ikc - thank you for sharing! You are an inspiration! That is exactly the type of story I needed to hear!

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  • CameraKim
    CameraKim Member Posts: 81
    edited July 2013

    Thank you for posting IKC! I was having a very random worrisome day and your post made me smile and again gave me hope!!

    I also had LVI and we know it had spread to one axillary node. I also am NED right now...but the thought always lingers in the back of my mind as I'm sure it does to most of us!

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  • Youngwithbc
    Youngwithbc Member Posts: 167
    edited July 2013

    Thanks for posting lkc... happy to hear :)

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  • Allagashmaggie
    Allagashmaggie Member Posts: 92
    edited July 2013

    My path report after surgery also said "suggestion of lvi present." Initially, my biopsy indicated low grade and it was thought I would just need radiation. But not only did I have grade 3 (high), I had lvi and an onco score of 24. My mo said it was my call on chemo and I decided to have chemo. She did not really seem concerned over the lvi and I have the impression that if my onco score had been lower, she would not have considered chemo even with the high grade and lvi. My sentinal nodes were clear. But......I obviously think about it as I went looking for this subject here on bc.org. I plan to revisit this next month with my doctor on 4 month checkup. Handling arimidex well overall after 15 months of taking it. Glad to have found this thread. Thanks.

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  • mdg
    mdg Member Posts: 3,571
    edited July 2013

    I also had LVI and my docs didn't really say much but I read it on my pathology report.  Once I googled it I was scared! Everything I read was not good.  I had clear nodes and an oncotype of 17.   I got two opinions from two different MO's.  One suggested chemo and tamoxifen and the other only recommended tamoxifen.   I had to make the call on my own.  I chose the chemo.  I did not want to have regret...my son was only 4 when I was diagnosed and I wanted to treat things aggresively.  I am glad I did the chemo.   It was not as bad as I thought (not that it was fun or anything......)

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  • Tineandjoe
    Tineandjoe Member Posts: 6
    edited June 2017

    Just wondering how you were this many years later. I too have LVI and they recommended the same treatment.

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