Invasive ductal carcinoma with lymph vascular invasion

The initial diagnostic process can be very stressful. Do you have an oncologist? I think you'll need to discuss the pathology report with whoever is the first person you'll be meeting with on your cancer team. Do stay in touch as the treatment plan gets clearer. I'm sure you'll get more responses here as well from those who have similar experiences. Wishing you the best.

@everything if it is breast cancer, I had the exact same diagnosis. Grade 3, high ki67%, lymphovascular invasion (focal). Find out if the lymphovascular invasion is focal or extensive. If focal it is just close to where the tumor was which is a better scenario. They can also tell you if it is in the lymph or blood vessels.

If your tumor is hormone positive (ER+) and HER2 negative, you will have an Oncotype Dx test that will tell you risk with and without Tamoxifen (you can substitute aromatase inhibitors which might be slightly better), and whether chemo will be of benefit.

I had a double mastectomy and 5 years of an aromatase inhibitor (letrozole) and am ten years out knock on wood. No radiation of chemo was suggested by any of the 4 doctors I saw.

Doctors don't discuss lymphovascular invasion much for some reason. Find out more if you can. But my story I hope is reassuring.

Hello @everything it sounds like you are having a time. Most of us have been there and understand the tons of questions without really knowing what to ask. Ductal carcinoma is the type of breast cancer that starts in the milk duct. You should get a stage based on size of tumor and the lymphovascular involvement. There will likely be, some more testing to help determine a treatment plan. Do you have someone who can go with you to see the oncologist, there will be a lot of information coming at you, and a second set of ears can be really helpful.
How are you holding up? Have you started working on a list of questions yet?

@autieoakely and @everything They don't include lymphovascular invasion in staging (but lymph node positivity is included) and it is not taken into consideration by tests like the Oncotype, which concerned me. If the LVI is focal, that is less of a worry.

I just had a similar diagnosis only it was extensive lymphovascular involvent. My nodes were negative. I had a mastectomy w/ direct implant and my Oncotype score was 22 and an 8% recurrence if I start a hormone inhibitor. Dr. told me not to be concerned about “extensive lymphovascular involvement”. Again there was no spread to my nodes. I hope this helps…. Ask specific and direct questions Ben you meet with Oncology! Best wishes to you❣️

@srkellen did they explain why extensive LVI was not a concern? I was told focal was not a concern but that the issue wasn't even the location but the fact that this invasion showed cells who "wanted to travel." So in that sense it would seem to make no difference where the LVI was located. Mine was in lymph vessels. I did wonder if a biopsy could give the impression of LVI- since I have stayed okay for so long!

The oncology surgeon didn’t explain well enough but did say all my cancer was contained in the breast and he considered me cancer free.. I have an appointment t with the medical oncologist in Jan. and I’ll see if I can bet a better explanation and share that with the group.

I was diagnosed with the same in June. I'm 76. ER+ and started taking AI. Had surgery in Sept. 2 nodes were pos. They got clear margins on both lumps and nodes. Recommended radiation,but I chose to forgo it and just take Anastrozole. The choice not to radiate is a personal one for each of us. Time will tell if it comes back, but I am comfortable with it.

Lymphovascular invasion is not the same as positive nodes, just to be clear. Lymphovascular invasion is still contained in the breast.

I was able to avoid radiation by having a double mastectomy. I was told one out of five radiologists would have recommended radiation. I am ten years out knock on wood.

Technically a precursor to node involvement, means it is found in lymph vessels in surrounding tissue. Sometimes also used as a term to describe to cancer in the blood vessels in the tissue surrounding a tumor. This isn’t necessarily confined to breast tissue or even breast cancer (further clarification).
It is a determining factor when considering a treatment plan as is angiogenesis (the tumors ability to create new blood vessels in order to grow).
Did you have positive nodes as well?