LVI (Lymphovascular Invasion)

Hello, SadlyNew! Thank you for starting this thread. I also hadLVI and my doctors are all very optimistic about my prospects. They said to not trust Dr. Google. Let’s hope more people will show up with positive stories.

I am glad you posted this!

I had LVI and am starting my 4th year of treatment with Femara: so far so good in terms of cancer.

I had a grade 3 (one hospital said grade 2), highish ki67%, contradictory HER2 results (finally resolved as negative with a higher number of cells counted), mixed ductal and lobular.....and LVI, which was "focal" and specifically seen in lymph vessels.

But my Oncotype was 8. My doctor had it retested!

I had 4 different oncologists in 4 different hospitals in those first months. The two main ones were so chirpy about my prognosis that I barely trusted them. The third one said "I don't blame you for being troubled," and did the retest of HER2 and Oncotype and offered me chemo or whatever else I wanted. I said no to chemo with that Oncotype because I figured it wouldn't work anyway.

So, back to LVI. Google claims that LVI is equivalent to one positive lymph node. None of my doctors has said that about focal, but there is very little info on focal versus extensive. My doctors did make that distinction.and were reassuring, as was my surgeon (The Oncotype recommendation for one lymph node wouldn't have been different anyway. )

My understanding however is that it isn't so much about where the cells are but more about the type of cancer cells we have, which, as my favorite oncologist said, LVI proves "want to go somewhere." (My surgeon said the location of cells was not relevant and made motions to show me that they wouldn't be better able to crawl out just because they were located nearer the armpit!)

I believe everyone had cancer cells circulating so I resolved not to worry about the image of escaping cancer cells. But I do worry about having cancer cells that were able to move and settle somewhere. Which means they have the capacity to spread.

Also, think about it: they found LVI present but how many people have LVI that is not detected (and do fine)? There is really no reliable way to test the consequences of LVI because there is no way to be certain it isn't present- unless the pathologist is able to look at every single vessel, including those outside the surgery area. Am I wrong?

Anyway everyone tells me my prognosis is good, and so far, it seems to be. If your tumor responds to estrogen and progesterone, all the better.

Genomic Health, the maker of the Oncotype test, says that 30% of grade 3's have low Oncotypes.

This cancer business is so much more complicated than people think

Hi Sadlynew2018,

I have a thought for you.  Instead of Googling LVI (Lymph Vascular Invasion), look up ways you can improve your Lymphatic System.   There are a lot of things that you can do to improve your prognosis, along with the Doctors' recommendations that you choose to follow.  If your lymph system is healthy, your estrogen and progesterone will be better regulated, amongst several other benefits.  I find it distracting and even enjoyable to rise to the challenge of becoming healthier.  Why not feel better and look better while going through this journey!

Lori

Well, yeah, my biopsy results said HER2 + and I bought a wig and baking soda for my mouth after chemo etc. 

Pathology after surgery was negative, equivocal, then negative with a count of higher number of cells.

I had differences in grade at all 4 hospitals, some 3 and some 2. That really isn't significant, according to doctors and I don't give that much thought.

I am not saying that I don't trust pathology. But I was told the HER2 with biopsy may have been from having proportionally more DCIS cells versus invasive cancer cells in the sample, and DCIS tends to be more HER2+.

And I heard somewhere that if a post surgery sample has some tissue where the biopsy was done, it could look like LVI because cells get dragged around. Sorry I can't remember specifically so don't go by this rather vague info. Main idea is that there can be things that affect pathology results that we don't know about.