Dermal Lymphovascular Invasion

I had lymphovascular invasion. It did not alter my treatment plan (no chemo, no radiation, mastectomy and hormonal meds). I read that it is equal to one positive lymph node. However, it makes a difference whether it is focal (localized near the tumor) or more extensive. Also do you know if it is in your lymph vessels, blood vessels or both?

My doctors did not express concern. I had 4 opinions! The tumor board at Dana Farber also didn't seem concerned. I think they relied on the Oncotype, which was low despite grade 3 and LVI.

Let us know more about the dermal form of this if you can. I would also advise not letting Dr. Google scare you. I am 8 years out knock on wood.

I see the oncologist again on the 24th. I'm hoping for better answers then on what it actually means. His biggest concern was that the tumor had invaded the dermis. The pathology report says "Skin Satellite Foci" "Satellite foci not identified". The initial recommendation was surgery, radiation, and hormone medication. The first time that chemo was mentioned was at this last visit with him. I really don't know anything else right now except that it's scary.

I found this: Satellite tumor nodules in the skin are separate from the primary tumor and macroscopically identifiable. Skin and dermal satellite nodules identified only on microscopic examination and skin involvement without epidermal ulceration or skin edema (clinically peau d’orange) do not qualify as pT4b category (Fig. 4A, ​,B).B). Such tumors should be categorized based on tumor size. Inflammatory carcinoma is categorized only when there are clinical symptoms of erythema and edema in more than one-third of the entire breast skin and not by the pathologic findings of tumor emboli in the dermal lymphatics. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7829577/

Info on the pT4b category https://pubmed.ncbi.nlm.nih.gov/18215492/

What I got, as a lay person, is that the cancer in your skin has a better prognosis if it has not broken the skin. Dito if swelling/redness covers less than 1/3 of the breast. But a doc could interpret and explain.

I've seen these articles in looking for the phrase. There really isn't anything out there that provides any good information. But thank you for looking around. And congratulations on your 8 years out!

Hi Sandy, what did you learn at your appointment earlier this week?

He's done a complete turnaround on chemo BUT the oncotype test hasn't come back as of today (11-6). They sent the document off for it but the company didn't get the last page. It was sent back on the 24th and the sample was sent on 10-31. If I score higher than 28, he said we'd talk again. I asked him about the dermal invasion and he said that "there's dermal invasion and there's dermal invasion". He doesn't seem concerned now which puzzles me since I reread his after visit notes and he clearly noted that we discussed the probability of systemic chemotherapy. On the plus side, I was finally able to visit with radiology and get my markers on for radiation...but if the onco score comes back high, the oncologist said he would stop radiation and start chemo. The radiologist disagrees though.