Does lymphovascular invasion mean a poor prognosis with no chemo?
Dear Maggie281,
My pathology report said “Vascular invasion”. This meant that the tumour had invaded blood vessels so some cancer cells could have got into the bloodstream.
“Lymphovascular invasion” implies that some cancer cells could have got into the blood stream or lymphatic system. So they could lodge elsewhere and start to grow.
My Grade of cancer was grade 2, so middle “speed” of growth.
I decided to opt for chemotherapy to kill off any stray cells which may be floating around…but it wasn’t an easy decision.
Make sure you understand ALL of your pathology report because you need to piece together ALL the factors…how big the tumour was, how fast it was growing, whether it is “fed” by hormones etc.
This Breast Cancer Care website is brilliant for helping you understand it all, bit by bit. Their booklets are very clear and you can phone up to speak to a breast care nurse with any questions (as I have done many times!)
It can take time to make decisions, I find this the toughest bit. There seem to be no crystal clear answers. I hope you don’t feel too swamped by it…keep asking questions until you come to something you are comfortable with. We’re all here to egg each other on!
Hi Maggie
As hearty has suggested, please feel free to call our helpliners to talk your results over, we also have some information on this site explaining pathology results along with a booklet which you can read here:
Helpline 0808 800 6000 weekdays 9-5 and Saturday 10-2
Here’s a link to further support from BCC which you may find helpful:
breastcancercare.org.uk/breast-cancer-services
Take care
Lucy BCC
Hi Maggie281
I’m grappling with this dilema at the moment too, so I’ll share my understanding of it so far.
My cancer was grade 1, with no node involvement. However after having my Mx and DIEP, I went to see the onc for my histology report and he said that he was just going to discuss with the registrar whether I’ll need chemo!!! This was news to me as chemo had never been mentioned and I’d assumed that because there was no node involvement, I wouldn’t need it.
The registrar came back in and said that they had put all of my details into their database and it reported that chemo would be too harsh for the benefits that I would get. This was the first I had heard about my cancer being LVI, so for me it was like being diagnosed for the first time.
He said that when they put my details into their database, my survival rate was 98% - fantastic! Chemo would’ve only given me an extra 2% survival. The tamoxifen would help as my cancer was hormone receptive.
I have since spoken to my bc nurse and she reiterated what was discussed and said that if the chemo came out as giving me an extra 4%, then they would have prescribed it.
I guess I could push for chemo if I wanted, but I’m trying to take comfort from the 98% survial rate without it, which in itself is a good prognosis.
I suggest to you that you find out the percentages, if they feel that you need the chemo they will give it. Was your cancer hormone receptive? Will you be given tamoxifen?
I hope this helps.
H x
Hi maggie
Please don’t wait 6 months to see your onc, insist on seeing him/her now.
Someone on the forum previously suggested this to me and I got to chat with the bc nurse, who managed to allay some of my fears. You can’t possibly wait 6 months to have it explained to you.
I’m going to have some counselling as although I’ve been given 98% survival rate, I feel unfinished. Like you, I feel like ive just been diagnosed, but worse in a way as they won’t be doing anything else. I have to keep reminding myself that the tamoxifen is going to do the same job as the chemo would do.
I looked at all my old letters a while ago and the lvi had been noted after my initial lumpectomy but back then I was totally oblivious to what lvi stood for!
Sometimes I wish the onc hadn’t told me. I think ignorance would have been bliss on this occasion as there’s nothing I can do anyway.
I’m probably not helping much other than to make you feel understood, I hope that alone helps.
Please don’t wait 6 months.
H x
Hi maggie.
I hope the onc makes some sense of it all. Keep us posted.
Quite frankky it’s not for them to decide what we want or need to know. It’s our body! If my initial breaat surgeon had of told me from the start that my tumour was lvi and that there could be a possibility of chemo then I may have had time to get my head around it. But I was told by the onc on my follow up appointment after the mastectomy, the breast surgeon had all the info after the lumpectomy, like you, I felt like I had been diagnosed all over again.
Please let me know what they say.
H x
Hi everyone I am on holiday and have noticed an indentation in my other breast there is a small lump above it, surely it can’t be back again I am taking tamoxifen!
Hi maggie. I cant believe this. So sorry that you have this worry while you are trying to enjoy a holiday. Make sure you get examined as soon as you return. It may be nothing just as sarah said. H x
Hi everybody was at breast clinic on Tuesday,had mammo and scan and nothing suspicious was found. I am so relieved. No apt for oncologist yet.
Maggie x
Hi maggie. So glad you posted. You’ve been in my thoughts and I have been meaning to post and ask how you are.
What a relief!!! I’m so pleased for you.
Take care.
H x x
Hi I’m new to this but was drawn to the lymphovscular invasion heading.
I was diagnosed with ductal invasive carcinoma last November. The ultrasound results indicated 2 tumours one grade 2 and one grde 1. My consultant insisted there was only one tumour.
After my surgery my consultant said he had "found a second tumour " ! - what a surprise!
One tumour is 18mm the other is 15 mm both are of “no special type”. The larger one is grade 2 the smaller is grade1(15mm) .
I also have a “strange” area where I was accidentally burnt by the surgeon with a cauterisation tool which looks very indented and red.
Lymphovascular invasion is present.
I had Sentinal lymph node surgery which was clear.
I am ER positive.
Also noted is that the larger tumour is associated with a fibroadenoma.
Should I have been offered chemo therapy?
I am concerned as everything that I have read indicates that I should have had chemotherapy- I had surgery,radiotherapy and endocrine treatment- tamoxifen- even though I am post menopousal as I can’t have AI as I already have osteoporosis).
Hi Janeliz and welcome to the BCC forums
Along with the support and shared experiences you will find here please feel free to call our helpliners to talk through the concerns you have on 0808 800 6000, lines are open weekdays 9-5 and Saturdays 10-2
Here’s a link to further support services from BCC which you may also find helpful:
breastcancercare.org.uk/breast-cancer-services
Take care
Lucy BCC