Invasive ductal carcinoma with lymph vascular invasion

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?

@autieoakley I was told by my doctors. that LVI was confined to the breast and that focal lympovascular invasion is not really a precursor to node involvement. They did not mention angiogenesis but instead said that LVI indicates cells that "want to travel." They did not connect LVI to node involvement at all. My nodes were all negative.

Since your interpretation differs from what I have told, I want to research. Can you share a source?

Here is a few;
American cancer society
https://acsjournals.onlinelibrary.wiley.com/doi/full/10.1002/cncr.26711
Here is a couple different ones from NIH
https://pubmed.ncbi.nlm.nih.gov/25855161/
https://pmc.ncbi.nlm.nih.gov/articles/PMC7279808/
And here is an easy to understand graphic for patients
https://www.mypathologyreport.ca/pathology-dictionary/definition-lymphovascular-invasion/
I hope this can encourage a wider view of pathology and the way that it guides treatments.

@auntieoakley I don't see much that is new in these studies, despite the fact that they are much more recent than my own cancer and research back then. The studies do describe LVI as in the "peritumoral area" which means on the edge of the tumor, still in the breast.

I have read that it can be seen as equivalent in risk to one positive node but the first study you cited said 1-2. That study did not apparently differentiate between focal and extensive and it is unclear there whether focal is lower risk.

They also did not differentiate between lymph and blood vessel invasion. If Lymph, the cells had not reached the nodes or they would have shown up in the sentinel node, I assume.

In my view all of this means the studies are flawed and we need better ones.

All of this is scary for me at 10 years. Doctors in 2014 didn't even want to discuss LVI, it wasn't considered in the Oncotype (mine was weirdly low with LVI, high ki67% and grade 3) or any of the online risk calculators. I personally feel that those of us with LVI should qualify for the Signatera blood test that those with 1 lymph node qualify for, to test for spread.

I like to think it was all removed with mastectomy but cells could have gotten through and the important factor is the ability to travel and implant of these cells.

How the heck are we supposed to catch metastasis? My surgeon says focal persistent pain which many of us older folk have. With 7 spinal fractures, lumbar and cervical stenosis and osteoarthritis I am not going to pick up on a particular pain.