Breast Cancer and Perineural Invasion

cashemire,

That's interesting what you said about pain because I had terrible pain in my breast and I recall how uncomfortable the seat belt was on my breast. Some people think that breast cancer is not painful but they are so wrong.
Isn't it frustrating to not know the ramifications of the nerve involvement? It's been around 2 1/2 years since my surgery and radiation and I still have deep nerve like pain in my breast that comes and goes.
Now I have developed transient lymphedema in my breast. I didn't even know that you could have breast lymphedema.
Thank you for telling me about your experience. I appreciate it.
Katrina

Good morning everyone. I was told a week ago that Perineural Invasion is present after doing a double mastectomy. However , my margins are negative for carcinoma. My oncologist are suggesting chemotherapy. After surgery the pathology report read that the cancer was not in my right breast and no spread to my lymph nodes from my left breast which had the small tumor. I do not want to do chemo. Any suggestions.

Had perineural invasion indentified on pathology for invasive lobular carcinoma. Had lumpectomy & met with Dr's today to discuss treatment plan. I asked about PNI & Dr told me not to worry because cancer doesn't travel down the nerve with breast cancer. I really didn't like that answer..Everything I see online states its rare in breast cancer & there isn't much info, but its not good in prostate cancer..Anyone have anymore info????

I used ScienceDirect.com to look this up. I’ve found this site often has info that is very new, sometimes not yet published. It seems most of the info about pni is associated with TLSs - that’s evidently something they’re doing more research on now, and have finally included breast cancer. I found it all a bit unclear. But it seems perineural invasion is found in many breast cancers but in non-significant amounts. It may or may not be an indicator of problems (this is my unprofessional understanding of what I read) but it is an indicator of aggression in TNBC.
I put the links I found below, plus one about TLS from Nature.com that explains what it is.

Tertiary Lymphoid Structures (TLSs) and Stromal Blood Vessels Have Significant and Heterogeneous Impact on Recurrence, Lymphovascular and Perineural Invasion amongst Breast Cancer Molecular Subtypes
https://pmc.ncbi.nlm.nih.gov/articles/PMC10136904/
5P Tertiary lymphoid structures (TLS) presence and stromal blood vessels heterogeneity differentially influence recurrence, lymphovascular, and perineural invasion in breast cancer molecular subtypes
https://www.sciencedirect.com/science/article/pii/S0923753423023451?ref=pdf_download&fr=RR-2&rr=94a25367be6e69d3
Perineural invasion-associated biomarkers for tumor development
(No breast cancer mentioned, but just about every other kind!)
https://www.sciencedirect.com/science/article/pii/S0753332222010800#sec0005
Tertiary lymphoid structures in the era of cancer immunotherapy
https://www.nature.com/articles/s41568-019-0144-6

@kluckett75, you may also be interested in the discussion that @katrina123 started on this topic:
- Breast Cancer and Perineural Invasion https://connect.mayoclinic.org/discussion/breast-cancer-and-perineural-invasion/