What are the chances of vascular invasion?

Hi All

Having had a WLE and SNB last week and being led to believe that the sentinel node was clear, I had been really relieved. Now I have found out about vascular invasion and I didn’t realise the bc could have spread that way. Now I am worried again. My results’ clinic is next week but I wanted to ask you ladies if anyone with clear nodes did have vascular invasion (or not, which is what I am hoping, obviously!). I have/had mixed invasive lobular and ductal bc, grade 2, size about 2cms before op (don’t know what they actually found), strongly hormone positive. I am trying to work out how worried I should be. I know I should just be patient, because everyone is different, but I really would like to know. No-one mentioned it to me at the hospital.

The other thing is, my scar is really long, considering the size of the lump - about 9cms (the scar, not the lump!). I don’t understand why, and that has worried me, too. It is not that I am bothered about the scar, just why the need for one that length?

Sorry to have to ask you this, but everything seems to worry me now, and this really is the best place to find out information.

Love Ann xx

My scar is also about that length-they need to have room to take out the tumour and surrounding tissue so they can check for clear margins of cancer free tissue.Mine also has a T shape because the node sampling was done through there too.Believe me the scar will be no bigger than necessary.
Re ascular invasion-you may have to ask specifically when ypu see the surgeon.I hadnt heard of it and it must have been a year post-op before I asked.I was shown the histology report which said quite clearly ‘no evidence of vascular invasion’.It also mentioned an area of DCIS round the tumour which is apparently normal and the clear margins are round that as well.You do need to ask though.

Hi Anne,

My wife had 2.5 cm grade 3 IDC with 2 axillary lymph nodes involved. She had mastectomy and full axillary node clearance (I think because we already knew about the 2 nodes). In her case there was no vascular invasion. So you probably should not be too worried. (Easy to say, I know.) You should ask, though. They didn’t mention this at the appointment following the path analysis until I specifically asked.

You should ask for a copy of the pathology report as well. We didn’t get one at first, but then asked the oncologist for one at our first appointment with him. It told us lots of things that we didn’t know from the appointment with the BC surgeon, possibly because when they speak to you they tend just to pick out the main things they think you want to know about. We found it very reassuring to see the full report.

Thanks, jansman, that’s encouraging. It’s all about peace of mind, isn’t it? I shall definitely ask for the pathology report. I like to know all the details. I was trying to find out if these things happen in a certain order, ie lymphatic invasion followed by vascular, or vice versa, or whether it is completely random. I know I am clutching at straws in trying to guess the outcome and I really need to wait for the results, but it is so hard waiting.

I do hope things went well for your wife after that. I don’t think I have read your other posts, so I hope I am not being insensitive.

horace - I was only surprised at the length of the scar, because when the registrar marked me up pre-op, the line was only about 4cms long.

Take care, all. Ann x

Hi,
well sorry to tell you that I had clear nodes but was told that vascular invasion was starting. Fortunately it had not reached a blood vessel. I had IDC, a 2.3 cm tumour,grade 2, ER+,PR+ HER- and told I was bang on average for BC. They seem to think mine still looks fine, despite this. They do not happen in order. Another thing where we all have different things going on I guess.I am so sorry if this causes you more concern. My scar is just under 2 inches and they cut around the nipple and tunnelled up so it is just like a fine red pen line now. Just lucky that all our team are onco plastic surgeons so most people in our area seem to be happy with that aspect. I would say ask all these questions when you go. Maybe write them down so that you don’t forget any on the day when feeling anxious. Just one more thing don’t ask anything that you would be better off not knowing as you cannot erase it from your memory once you get the answer. It doesn’t change anything but might worry you more. I just generalise like ‘oh its not too bad then?’ and then dig a bit deeper if I like the first answer.
Big hugs and sorry again if I burst your bubble with this post. Good luck
Lily x

Thank you, Lily - Well, I did ask, and really want to know. Did you have chemo, then?

Ann x

Hi i also had clear lymph nodes but was told i had vascular invasion also in blood system, original told dcis and had choice of lumpectomy or mastectomy i chose the mastectomy and was told i had def made right choice as it turned out to be grade 3 invasive ductal carcinama with multiply tumours the largest 1 cm I had mastectomy with immediate recon followed by chemo but no radiotherapy as id had a mastectomy am also her2 possitive and just started herceptin. julie

Hi Ann I’m in the same boat as you. grade2 mixed lobular/ductal but 5cms locally advanced with lymphovascular invasion and her2 +++ my lymphs were clear., today 12 months ago I was dx, I also had skin involvement.
I to worried myself sick when I saw lymphovascular invasion,i had mastectomy and some skin removed 6 months ago.
When I had my lymph nodes removed I had a longer scar than I expected as well.
I think it is natural to worry,I’ve had a bone scan and ct scans and all clear so far. Keep positive take each day as it comes try and arrange something to look forward to and focus on that it works for me.

kernowdaisy - You said you had a mastectomy 6 months ago. Did you first have a WLE, then, if you were diagnosed a year ago? Presumably, you had chemo?

Ann x

hi ann
after having a wle and snb i had clear nodes but had vascular invasion.they removed the vessel that they found it on.i was told before the op that i would probely not need chemo but once they found this i had to have chemo.i am now on my 5th fec and i was so scared when i found out i had to have chemo.i must say that chemo has not been as bad as i thought.yes you do feel poorly but you do just get on with it.i cant belive that my next one will be my last the time just flys.i hope this helps you.
best wishes
jenny

Hi Ann and everyone else :slight_smile:
Yes I had epi/cmf chemo which was for 28 weeks. You know as the news started to sink in that I had cancer I moved from being scared and running to scared and fighting back. So at my initial appointment I just said I’m not having chemo before they even mentioned it. The BCN talked to me about giving up maybe 6 months of my life now to have the whole of my life left instead. It just suddenly dawned on me that they would not be bothering to even try to talk to me about it if they didn’t think it was the best thing for me. When I saw the surgeon for the next appointment I just said I want chemo. I am not sure what changed my mind but most likely my husband, children and little grandson. At the same time my friend got her Bc back and was really enthusiastic about having treatment as she had a microscopic tumour first time and no treatment, which had obviously failed to keep her safe. I decided to go on a research trial as I have now put my daughters on the line too. You get superb care on those and I will be tracked till the end, no matter how old I am. It helped me to think at least something positive could come out of this time. Thousands of ladies before me bravely tried chemo in the early days, etc to get to the good stats many people have now and this will continue if enough people go on a trial. I was scared stiff in the early days but just thought about the one next thing I had to do and ignored the big picture. You can do this and every treatment you have gives you a better chance of beating it.
Lots and lots of luck, do ask if I can help in any way. I had 8 chemo, 15 rads and I am on tamoxifen now
Lily x

Hi ann I did not have wle but had neoadjuvant chemo for 6 months first to shrink tumour, then had mastectomy followed by rads. I have been on herceptin since, going for heart scan tomorrow. I needed chemo I was 40 at dx,I knew there was no option for me from day of diagnosis I knew I had to have it to have a good fighting chance.

Thanks for that, ladies. I shall just have to keep my fingers crossed for next Thursday.

Ann x

Got some of my results today (Weds). Thankfully no LVI and sentinel node clear. I am so pleased. Will find out about margins in clinic tomorrow.

Thanks for your messages. Love Ann x

Great news. Good luck with the rest of it. I really hope you have wide, clear margins.

Thanks, jansman. With the length of scar I have, I certainly hope so!

I shall definitely ask for a copy of the pathology report, as you suggested.

Ann x

Hi,
one less worry for you, congrats and good luck with the rest
Lily x

I got the rest of my results today - clear margins! I am so relieved. I asked for a copy of the path report and they will send it to me. I have to wait for an appointment with the oncologist now - rads and hormone therapy, I believe.

Thanks for all your good wishes. Love and good luck to you all.

Ann x

Hi Ann,

Glad to read your posts. I had WLE last week and I don’t yet have all of the results back so like your first post - I’m sitting here desperate for news so I can plan the next stages!

I know my margins were clear and that my nodes were clear…Oh my tumour was 12mm and the scar is way bigger - but luckily not where anyone will see it so I’m not too worried about that.

Will find out soon what the histology says and vascular invasion was one of the tests they are doing. Looks likely though that they will recommend chemo. Not happy about this but being positive that 6 months of hell now - when I am quite fit and healthy pre-treatment will ensure that I am here for a long time to enjoy life to the full - I’m 39!

Badgie. XX

Hi Badgie

Just wanted to say that with a 12mm lump and no nodes, you may not neccessarily be given chemo.

I was 34 when dx 20 months ago and at first they told me I would need chemo. When I went for results of wle I was told 21mm no nodes, grade 3, but because I was 8/8 for both hormones I was told I wouldnt need chemo as I could have rads and 2 hormone treatments instead.

Everyone is different but your lump was very small and no nodes is great, so it will now depend on vascular invasion and hormone status.

Best of luck.