Lymphovascular Invasion Present

Posted by annkitz @annkitz, Sep 11, 2022

Has anyone else found this on your pathology report? If so, how did it affect your treatment decisions?

Interested in more discussions like this? Go to the Breast Cancer Support Group.

@annkitz I have not, but one of my dearest friends did. The advice she got from one cancer research institute and one large teaching hospital was pretty aggressive treatment plans, she is currently doing well after aggressive treatments. First things first, did your doctor order a PET scan yet? This will help determine if it made it to other places in your body. Cancer used the lymphatic system as one way to travel around the body. Treatment decisions should be based on the most possible information. For instance if it is only in the lymph nodes, you might treat aggressively to stop it there. If it has spread to one place you might try some targeted radiation to help. The best decision would be the most informed decision.
I know this is a scary time. I would love to help you understand more, if it could ease your mind some. Can you tell me more about yourself and your pathology report?

REPLY

Hi,
I have a meeting tomorrow to discuss the MRI results and the surgery plan. I was told that the MRI shows the cancer is spreading enough that the left breast must be removed. There will also be a test tomorrow on the right side with MRI guided needle biop before I meet with the doctor to discuss the events of a surgery she has already scheduled for the 21st, and other treatments I will also undergo, one of which will be a hormone blocker.
I am 56, and I have no history of cancer, though most of the women in my family have had breast cancer, my mother had bladder and brother had Non Hodgkins Lymphoma.

REPLY

I had lymphovascular invasion. It was in the lymph vessels, not blood vessels, and was close to the cancer, not distant. Apparently distance from the tumor is important.

I had two mastectomies and hormonal treatment. I was told that one out of five radiologists would have recommended radiation. I did not have it.

My Oncotype Dx was low at 8 but I had grade 3 (one hospital said grade 2), LVI, high ki67% and equivocal HER2 that had to be retested and was kind of borderline but considered, ultimately, to be negative.

So just letrozole (Femara) and just for 5 years. I am 7 1/2 years out.

None of my doctors expressed a lot of concern about the LVI, and my treatment plan was affirmed by a tumor board at a major cancer center. My research initially indicated it was equivalent to one lymph node being positive, but I later read that it is better if the LVI is, as I said, closer to the tumor. Nothing made it to the lymph node.
Hope my story provides some reassurance.

REPLY

I too had lymphovascular invasion present. LVI is not presently used in staging and the research is mixed on the subject, with some saying that it should cause an uptick in staging. Like most of what is said about BC, the importance of LVI appears to hinge on age, tumor size, grade, ER/PR /HER2 status, and histologic type. In my own case, my tumor was a low grade 1, relatively small in size, and my nodes were 0/4 clear. My Oncotype DX score was, like windyshores'', an 8 and a tumor board affirmed my treatment plan. It barely moved the needle on the Tufts IBTR tool predictions. Neither of my oncologists had much to say about my LVI, except that it is a negative (of course). However, it did influence my decisions to undergo whole breast radiation and to take an estrogen blocker. Hope this helps you.

REPLY

@annkitz, how are you doing? Did you have a follow-up with your cancer team to discuss the report and treatment options?

REPLY

I will be meeting with my medical team next week to discuss my pathology report and to determine next steps.
Thank you to those who have responded to my question about LVI.

REPLY
@annkitz

I will be meeting with my medical team next week to discuss my pathology report and to determine next steps.
Thank you to those who have responded to my question about LVI.

Jump to this post

Ann, I look forward to hearing your update (if you wish) after your meeting with the medical team about next steps. Enjoy your weekend and the things that bring you joy.

REPLY

What significance does LVI have for a breast cancer met to lungs w/ no lymph node involvement? Is the significance only a prognostic marker for treatment?

REPLY

I had LVI present in my initial (breast) cancer (in the lymph vessels). I was told "focal" was less risk than "extensive." In other words, if the LVI is close to the tumor it has a better prognosis. I was also told that LVI was equivalent to one lymph node, but they did not specify focal or extensive. Sorry about the mets! How did you find out?

REPLY
@windyshores

I had LVI present in my initial (breast) cancer (in the lymph vessels). I was told "focal" was less risk than "extensive." In other words, if the LVI is close to the tumor it has a better prognosis. I was also told that LVI was equivalent to one lymph node, but they did not specify focal or extensive. Sorry about the mets! How did you find out?

Jump to this post

wife had post covid cough (unrelated) and has asthma had cscan and 1.3 cm met in lung. not really sure how close it was in the pathology report but it did not specify

REPLY
Please sign in or register to post a reply.