Lymphatic/Vascular invasion

[Riesesdad]

Hi everyone. My wife just received the pathology report from her lumpectomy. They were to perform a SNB also, but it didn't work, so we don't know about any lymph node involvement. My wife really doesn't want to do an aux node section either.

She has IDC (Grade 1), 10mm, surgical margins are negative, ER/PR positive.

Anyway here are my concerns from the report....

1) "There is a focus of lymphatic vessel invasion at the periphery of the tumor"

2) "Focus of vascular invasion identified"

3) "There is also a focus of peineural invasion"

4) "A small focus of atypical lobular hyperplasia present less than 1mm from the medial margin"

I've done some quick research, and found that lymphatic or vascular invasion is a pretty good indicator of metastasis elsewhere such as this quote from a medical website:

"This often results in implantation of tumor emboli in adjacent tissues and indicates that distant metastases are likely."

Can someone please help me understand this better?

[Muttsmom]

HI,
I can't answer all your concerns, but I can tell you this. I had a 5.5cm tumor and 9 positive lymph nodes out of 16. They did a CT Scan, bone scan, chest x-ray and tons of lab work before I started chemo and I had NO distant mets. Just because you had node involvement does not mean that it has spread to organs or your bone. I know 3 ladies, one like me had 9+ nodes, one had 15+ nodes and 1 had 11+ nodes and none had distant mets. I'm 2 years and 8 months NED (No evidence of disease) and the other ladies are 4 yeras out and 6 years out. YOu always hope you don't have node involvement, but it doesn't mean it's gone to organs. I've seen ladies with tiny tumors and no node involvement and they have had reoccurences to the liver or bones. There is no rhyme or reason to this disease, I guess that's where there is no cure.

Things may have changed since I was dx, but my surgeon said that they check several blood vessels during my mastectomy and found no cancer cells in them BUT that didn't mean it hadn't gone into my blood stream from the nodes. Again, unless things have changed, there is no test to know for sure. Obviously if they found vascular invasion then it is in the blood stream, but either way, the treatment would be the same. Chemo and radiation. I had 6 rounds of Cytoxin, Epriubensin (sp) and 5FU and then 33 or 36 treatments of radiation (Thank God I'm starting to forget some of this nightmare).

I'd sit down with the surgeon and/or oncologist and ask them to explain the parts you don't understand. This is a very emotional time and I always had someone go with me because my brain shut down after hearing just so much.

Your wife will get in the "kick cancer butt" mode, like we all do and she'll get through all the treatments fine. It sucks, but she can do it. I know this is hard on you also, so don't hesistate to ask questions. Most don't ramble like me.. LOL

Take care
Nancy

[lizziecee]

Hi Riesesdad - I had a 2 cm stage 2, grade 2 invasive ductal cancer with associated DCIS.ER+. Had lumpectomy and 8 sample nodes removed - they didn't do SNB in UK then, 2003. 2 of the 8 nodes were cancerous, so I went back for total axillary clearance. Another 1 found to be cancerous, so 3/18. All bc tumours over 1 cm in the UK are treated with chemo, if patient agrees, and to my utter disbelief, some don't. I had a CT scan, bone scan, and chest x-ray after the surgeries, and no evidence of metastases was found.
So having some nodes positive does not necessarily mean the cancer has spread. I am now NED and thankful to be alive. The treatment is tough, but doable, especially with such a caring partner as yourself.
Hope all goes well for you both.
Liz.

[leo]

Hello

Lymphatic and vascular invasion is a sign that the tumor is locally invasive. Atypical lobular hyperplasia was also seen close to the surgical margins. I think you should wait for the sentinel lymphnode results, but your doctor will have to weigh the risks and benefits of additional treatment, but probably your wife will need more treatment: more surgery, radiation ,chemotherapy, or a combination of these.

regards
Leo

[Rachel Hamel]

My surgeon tried a SNB was unsuccessful, as was the other tracing tests they did. This is quite unusual for them to be unable to trace via the sentinel route, but does happen. As a result of the unsuccessful SNB, my surgeon removed 14 lymph nodes, and 2 of them were positive for cancer. He said they looked normal to the naked eye, but path results showed grade 1 DC 1cm tumor, clear margins er pr + heu -, and it was all done during the same surgery. I am very thankful he took this route. I would recommed that your wife either have the node disection or take the full course of chemo, with the assumption that she would have pos. nodes. You cannot be too cautious with this disease, and unfortunately, as someone else said, there is no rhyme or reason for mets, lymph node involvement, recurrence etc, so treat it as aggressively as you can tolerate. And positive nodes are not a death sentence, thank God. Good luck.

Rachel - Did you mean that your primary tumor was Grade 1, 1cm, clear margins er/pr + .

That is the same as my wife, but the surgeon said that with this low grade, small size that it was very unlikely to have spread. But judging by your post, it happens.

Thanks.

[Elena]

Hi, I've just joined this because I need to speak to people that have /been there..
I just had a look at my husbands hospital letter and as far as I knew everything was ok, as ok as t can be when you've been diagnosed with cancer.
He was diagnosed last year with follicular variant of papillary cancer and he had a total thyroidectomy.It was stage one and they said he would be ok and it didn't spread and that this was one of the types off cancer that often does not reoccur.
I try to be positive but doctors are so vague and hospital appontments are months and months apart.
Apparently its is avariant of papillary cancer and on the letter it says vascular invasion. What does that mean? What can we expect next? Does that mean it's not stage one ar that there is another cancer somwhere else that the scan did not pick up?
Not sure if the scan only followed the radioiodine or it scanned for any cancerous cells not necessary related to thyroid.
When someone is diagnosed with cancer, do doctors look for any other signs in the rest of the body.
Many questions but don't know who to ask...