Lymphovascular invasion present

Beaglemama · September 2016

Hi ladies,

So I had lumpectomy for right side mixed IDC and DCIS, ERPR+ HER2-, just under 1cm of IDC, about 6mm of dispersed DCIS that went up to two of the margins, so I had a re-excision last week. That pathology came back clean margins and I move on to radiation in a few weeks. My big question which I have received conflicting answers on is whether the presence of "a small focus of ,Lymphovascular Invasion", noted on first surgery pathology report) is something for me to be concerned about.

The BS says it is not an independent prognostic factor for recurrence or survival, but I've read in a dozen current respected medical journals that it IS is a prognostic factor. My 3 lymph nodes removed were negative, FWIW, and my OncotypeDx was 9. I'm 45 and premenopausal.

I HATE feeling as though I am not getting the full story. Has anyone else read this on their pathology report, or would you have any knowledge of how to contextualize this finding?

Thanks in advance.

katcar0001 · September 2016

Beaglemama -- That freaked me out on my report as well. None of my doctors (two MOs and one BS) were concerned about it. Only one RO I consulted was concerned, and I think he was looking for reasons to radiate. I decided against radiation.

You asked how to contextualize the finding--one thing you might look for on your pathology report is whether the LVI was focal or extensive. According to some studies I reviewed, focal is less of a concern. If it only says that LVI was present, then I would consult your doctors for more information. I think you have good prognostics with clear lymph nodes, clean margins, and a very low Oncotype. I know it is hard not to worry...

Olive4 · September 2016

Hi,

Wretched LVI!!!

I can relate totally to what you are saying having been in a similar situation. DCIS and IDC. IDC 8mm and er and pr+ her neg. 3 lymph nodes taken and all negative but had a focal LVI. I had grade 2 IDC. My oncotype was 7. I am 44.

I read lots and lots on LVI and got very confused and concerned and very hung up on LVI. It still seems a grey area.

I spoke with the surgeon, RO, MO, and even emailed the oncotype company to get as much information as I could.

My MO said that based on my pathology alone that yes it did increase the risk of reoccurence but it was just one piece of the information along with the size of the cancer, hormone status and lymph node status. Based on my pathology report alone chemo would have only given me a 4% benefit. I was very much undecided about chemo. I did not want to go through it unless the benefits really outweighed the risk. When my oncotype score came in my MO said chemo would be of no benefit to me and I felt comfortable with that. If my oncotype had of been in the intermediate range I would have taken the chemo. I am heading for radiation next week and then start Tamoxifen.

Please feel free to message me if you have any further questions.

What is your MO recommending treatment wise?

Good luck and keep us posted on how you are doing.

Charlene1 · September 2016

Hi

I also have that on my path report

it just says Lymph-vascular present, I had a 0.9 cm IDC with micrometastises in 1 lymph node out of 4

but lumpectomy tissue came back as grade 3 , MO is running Ki-67 test and I will get those results this Thursday

but last visit she was talking 12 weeks of Chemo but wanted this test before she recommended it

but I would say all things are pointing toward it right now. But I do plan on asking her what the lymph-vascular present

means in my case and how big of a concern is it.

inks · September 2016

I had LVI and was under 40. I saw 2 radiation oncologists and both recommended radiation. With lumpectomy you would usually get whole breast radiation but because of the LVI they may do the chest wall, subclavicle and nodes as well.

Lymphovascular invasion present

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