Please share your experience with Lymphovascular invasion. Thank you.
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I was diagnosed with stage2 her2 positive. Had perjeta and herceptin, followed by mastectomy and radiation. My pathology report indicated lymph nodes had positive residual with lymphovascular invasion. My oncologist said that 20-30% chance something went out and circling in my body. Due to this, we are doing 14 cycles of TDM1 chemo after surgery.
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What about lymphovascular, but negative nodes?
I also had negative nodes. My first hospitals pathology was negative for lymphovascular invasion, but when I had my pathology retested at another highly rated hospital, they did find invasion. I also had 12 rounds of taxol/carboplatin.
I had "focal" lymphovascular invasion and one report specified lymph vessels. Grade 3, highish ki67%, but no nodes and low Oncotype. (My first pathology also had me as HER2+ but later pathology has equivocal then negative. I initially bought a wig and got ready for chemo.)
I had a double mastectomy, then saw four oncologists at 4 different hospitals because I was troubled by the test ambiguity and contradictions and also by the recommendation to only do hormonal meds. The 4th doctor understood my dilemma and retested Oncotype and retested HER2 with more cells (60 versus 20) so I could feel more reassured.
I met with radiation oncology on my own and was told one in five radiation oncologists might suggest radiation for me. But there were risks to it for lungs and with lupus.
I did letrozole for 5 years. Then did a Breast Cancer Index (thanks to breastcancer.org since my docs did not use this; it is now part of the NCCN guidelines) which said no benefit to further meds. I am 8 years out.
I read that LVI is equivalent to one node positive. I also read that it matters whether it is "focal" or "extensive." I even wondered if the biopsy could have created the appearance of LVI.
The significance of LVI isn't what I thought. The significance is that these cells show a desire to "go somewhere" and have the ability to implant. I was told that everyone has cancer cells floating around but only some of the cells have the ability to create metastasis. This is from memory so ask a doc!
Keep going with opinions until you are satisfied! You have to send pathology slides around but it is worth it if you are not feeling comfy with treatment plan.
I’ll go back to have 2nd surgery to remove armpit lymph nodes due to lympho vascular invasion and micromestatasis on sentinel lymph node. How soon after your surgery you started chemo?
Thank you for such details! I’m so worried for my lymphovascular invasion and will go back to remove armpit lymph nodes this week. Did you do chemo at the end? Did you have armpit lymph nodes removed during mastectomy?
Do you have positive sentinel nodes? Everyone who does axillary node dissection should do LVA surgery (Lymphaticovenous anastomosis (LVA) surgery): connecting the lymphatic vessels to nearby veins , allowing the lymph to drain into the veins and circulate back into the rest of the body. With this microsurgery procedure, the chance of developing lymphedema is greatly reduced.
First hospital did pathology after surgery or just biopsy?
Thank you. My Oncotype is 16, negative lymph nodes ( 6 sentinel nodes removed) and lymphovascular invasion identified. Meeting the oncologist on the 25th.
Full pathology. The first hospital just missed it. I was also consulting with another hospital and had them check it and they found some LVI. Very high ranking hospital, so I have confidence in their findings. However, since I had opted for a double mastectomy, they felt that there was a good chance it was all removed with the surgery. Since the first hospital missed it, I had hoped it was fairly minimal.
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