Lympho Vascular Invasion/breast cancer

[AWorriedMom]

Doctor, my daughter was diagnosed with invasive ductal carcinoma, stage 3a. She had 5 positive nodes and a 2.5 cm tumor. Her tumor is estrogen and progesterone positive and Her2 neg. She had a bilateral mastectomy. She just saw an oncologist who will be starting her on dose-dense treatment with ACT and then radiation. She told my daughter that she has a curable cancer. I don't know if she is being overly upbeat with her. Yesterday my daughter told me that her path report said there was lympho vascular invasion. I have scared myself to death as all I find on the subject is that it means a very poor prognosis. IS this still curable? And how bad is lympho vascular invasion? Thank you in advance for your answer.

[AWorriedMom]

Thank you so much for your comments about my daughter. She does have tons of support from family and friends and she has a very upbeat attitude. We are very confident in her oncologist. And she will be having radiation and tamoxifen. Her oncologist says she has some positive features such as 100% er and pr+ as well as ki67 <10. Her tumor was a grade 2.

Thank you again for your comments. I do best with information.

[hbmd]

Overall, the lymphovascular invasion is one of many features that factor into the prognosis for breast cancer. Since your daughter already has positive LNs, and there are over 4, she will very likely be getting radiation to that area, although she has already had mastectomies. While it is true that the features you describe, and her stage, are cause for concern, the ACT regimen and the additional treatment she will be getting are the very best that we know of in the current state of our studies. It is true that tumors with LVI are more aggressive and travel early. Clearly that is the case here since the LNs are involved. On the other hand, these cell types have been shown to be more sensitive to chemo and radiation, and therefore more easily destroyed by the treatments. There is nothing that can be done to control the situation other than staying as healthy and rested as she can, and to get through these well studied treatments. If she has your support, she will do well. While the final outcome cannot be predicted, it sounds as if her oncologist is doing everything right.

[John Irlam, DO, FASCP]

Hi there,
I'm very apologetic for your disappointment in this site and in my lack of a timely response.  With my schedule I can usually only answer questions on my non-call weekends.  To simplify things lymphatic invasion is relatively inconsequential with positive lymph nodes as the cancer uses the lymphatic channels to gain access to the lymph nodes.  If the nodes were negative I think this would be more significant, but in this case tumor cells have already spread to the lymph nodes.  As far as curability goes I can't make much of a comment as I'm not an oncologist and my opinion would be purely speculative.  I hope this helps.  Feel free to let me know if any further clarification is needed.  
John