vascular invasion

[alli98]

Im thru bmx, 4 AC & 6 of 12 taxol/herceptin, but just noticed on path reports "lymphovascular invasion present." Drs never mentioned this to me. Tumor was
1.4 cm, er+ pr+ her2+, node negative (0/4), grade 3, stage I & that was all explained to me but LVI was not.
Does anyone know how significant LVI is to prognosis? Does it mean mets or recurrence is more likely even after all the treatment? Or is LVI just a factor like her2+ is that would warrant chemo where without LVI the patient might not have needed chemo? Would appreciate hearing from anyone who may have discussed LVI & what it means for prognosis & treatment.

[AlaskaAngel]

alli98,

The online decision-making tools like Adjuvant Online don't ask about LVI when estimating, but might have some discussion about their impression about it. If it isn't a clear and definite measurable factor for them, it likely isn't certain.

Comparisons are complicated. You and I have similar characteristics other than that I did not have LVI, and you probably didn't have CAFx6 like I did, and you probably did have trastuzumab.

You might discuss it with your onc to see what your personal path samples showed. How prevalent was it on the samples used in looking at your pathology?

AlaskaAngel

[Cal-Gal]

I would talk to your Onc about this-
Good Luck!

[alli98]

AlaskaAngel, what is CAFx6?

[alli98]

Oh I see what CAF is - I had never heard of that cocktail before. Anyway, I will ask onc & bs what vascular invasion means for me. I just think its weird they never mentioned it. Most things I ask them about after reading horror stories, they say are nothing to worry about so hopefully they same thing about LVI.

[AlaskaAngel]

Yes, CAF (sometimes also called FAC) and FEC both use similar drugs (Adriamycin for one, and epirubicin for the other). In the US, prior to using the taxanes those who were HR+ generally got CAF or FEC, and those who were HR- got CMF. CAF and FEC are still used in Canada, Australia, and Europe for some patients instead of a taxane, for those who don't get as much benefit from using a taxane. (Like me, for example.)

I think your guess about the thinking behind your treatment is correct and that the systemic chemo is what they would use regardless for the LVI. Your onc or the pathologist should be able to tell you how consistent and prevalent it was or not from your tissue samples.

A.A.

[rhondalea]

Here are a few articles about lymphovascular invasion (LVI), none of which were particularly heartening:

http://onlinelibrary.wiley.com/doi/10.1002/cncr.26711/abstract

Specifically for the node-postive folks:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3200515/

This is older, but I found it when I was looking for information about radiation (which I was originally told I would not need, but do need after all, partly because I had LVI). The section you want to read is under "Prognostic Factors":

http://theoncologist.alphamedpress.org/content/9/6/606.full

And another from 2007 with lots of tables and statistics:

http://www.belsurg.org/uploaded_pdfs/107/107_284_287.pdf

[alli98]

Thanks for articles rhondalea. Our treatment plans seems pretty similar except for the rads you are getting. I should b done with taxol in feb. Good luck.

[yanyan]

Hi, Alli. I think many here who had positive lymph nodes freaked about the path report. There are quite a few of us here in our 30s are diagnosed at stage 3. Vascular invasion, yes i had 10 out 23 and that was after 4 chemos. My cancer cell broke away from my lymph nodes as well, i think it is called external capsular invasion. When my surgeon told me i had 10 positive nodes i said,um not too bad only 10. He didn't not say anything. Later i found out what it meant and i couldn't pull myself out from "google". It has been 10 months since i started 1st chemo and there were so many bad dreams after surgery when things eventually felt so real as my scars proved what happened- i had cancer. There are still gloomy moody days but it is getting better. I guess what i am trying to say that you will be fine. I eventually came to understand that living today is the most important. I used to worry sick about my prognosis but it really sucks to live in fear and worry. Easy said, it is tough. I hope you will feel better soon. There is a life after cancer, it is upto us whether we want to live it happy as much as we can.

[rhondalea]

Thanks, alli. For the Taxol, you might want to look into acetyl-l-carnitine. There are several studies which indicate it minimizes or even prevents neuropathy. It worked exceptionally well for me, and I have no neuropathy at all.

Note to yanyan: lymphovascular invasion is not the same as positive lymph nodes. See here for a concise explanation:

http://www.dslrf.org/breastcancer/content.asp?CATID=28&L2=1&L3=6&L4=0&PID=&sid=132&cid=1104

[Cal-Gal]

YanYan-Great advice!!
I appreciate all the info and articles, interesting.

My situation is bizarre-

My LVI was indeterminate-inconclusive-in my case the lab test was negative-however when they 'viewed' it the 'old fashion way' it was positive.

My Onc considers and treats this as a Positive.

I was Stage 1, but treated as Stage 3, which I am thankful for everyday.

Here is to the famous quote and book by the same name by Ram Dass...... "Be Here Now"

That is what I practice everyday---

Love to ALL

[R.B.]

This may be of general interest. It is a fascinating review.

Tumor Angiogenesis as a Target for Dietary Cancer Prevention
http://downloads.hindawi.com/journals/jo/2012/879623.pdf


Clearly all the usual caveats apply as to seeking advice before supplementing