lymphovascular invasion or tissue displacement dcis

Just got my final pathology report after BMX, still pure DCIS. My Surgeon said no chemo, no radiotherapy and no tamoxifen.

After reading through the whole report, there is one additional comment I don't quite understand:

"In one block, at the edge of the tissue and partially within a thick walled vessel, there is a group of highly atypical epithelial cells (MNF116 positive). This is indeterminate for lymphovascular invasion and may represent tissue displacement. Further sampling of the specimen around this area shows no other significant lesion"

Does anyone see anything similar before? Is this anything I should worry about?

I had two lumpectomy before BMX since no clear margins, had SNB on trouble side during the 2nd lumpectomy, 3 nodes all negative.

Thx!

Comments

  • maggie15
    maggie15 Posts: 1,563

    Hi @allthebest2025, I did not have the same pathology but my tumor was positive for lymphovascular invasion. My surgeon and MO both told me this is an unfavorable finding but according to NCCN guidelines it is not considered when planning treatment. The strange cells found in your pathology are atypical but not cancerous and even if LVI were present (indeterminate means the pathologist can't tell) it would probably not make a difference. You should check with your doctor but you probably don't need to worry about it. I hope you heal well from your surgery.

  • needs.a.nap
    needs.a.nap Posts: 232

    Hello @allthebest2025. That’s good news that it’s come back as pure DCIS! How are you feeling and healing?

    That’s a great question to ask your doctor! I also had LVI present (& super stressed about it!!) but the oncologist wasn’t concerned. She didn’t feel it changed anything about the recommended treatment for me. I’ve asked several doctors about it and one time when speaking to a physician’s assistant at my oncologist’s, she made a comment that they question if it’s true lymphovascular invasion or if it’s from the surgery itself (in general, not specifically my case) … that’s what tissue displacement means … that cells get bumped around and end up away from the original tumor. I can see how that could happen, especially with the multiple stabbings of the biopsy but I wasn’t really convinced that explained my “LVI” since mine was already invasive.

    I’m sure you’ve already Googled it … here’s a pretty simple explanation I found (from Google AI … but please, please ask your doctor for clarification on your pathology report!!)

    “Lymphovascular invasion tissue displacement" refers to a situation where tissue from a tumor appears to be within lymphatic or blood vessels on a tissue sample, which can be misinterpreted as cancerous spread (lymphovascular invasion), but is actually just displaced tissue due to the biopsy process, not true invasion; this can be a diagnostic challenge for pathologists, particularly when examining core needle biopsies. Key points about lymphovascular invasion tissue displacement: 

    • What it looks like:Under a microscope, the tissue may appear to be inside the vessel walls, mimicking cancer cells invading the lymphatic or blood vessels. 
    • Cause:This often occurs due to tissue manipulation during biopsy procedures, where tissue can be physically displaced into the surrounding spaces, including lymphatic channels. 


    Take good care of yourself and try to rest!!

  • Hi @maggie15 and @needs.a.nap thank you so much for sharing your experience and information and kind words!

    I am 2 weeks post BMX, just got drains removed, so physically I am feeling good. My surgeon is the only doctor I have been seeing so far for my case. It seems that I won't be referred to any oncologist later, and I will see my surgeon in three months. She did discuss the diagnostic summary with me during the last appointment (pure DCIS, 1.5mm residual, clear margin), which concluded no any treatments needed, but didn't mention any additional comments listed in the end of the pathology report. Those comments brought to my attention after I read the whole report and caused my restful mind unsettled again. I did some research on LVI, and read some articles suggesting LVI should be considered as a factor on adjuvant therapy decision (but as maggie15 mentioned it's indeterminate in my report, so it's probably not a issue) and how difficult to differentiate LVI and cells displacement. I will bring this up with my surgeon. I guess part of the unsettled mind is also due to the uncertainty we are going to face after cancer diagnosis, surgeries are done, now what?

    Thanks again!

  • needs.a.nap
    needs.a.nap Posts: 232

    You’ve been through a lot @allthebest2025 and it may take time for your brain to catch up with it all (mine is still trying to catch up I think). I can see how you might feel like you should be doing something more. It really does appear that you found it early and eliminated the risk. Hopefully you can focus all your energies on healing!!

  • @needs.a.nap Thanks! May everything go well for you. I cannot fully express my gratitude for the result I got under this circumstances. And will keep trying to live as if this episode is behind me.