Lymphovascular Invasion, What Is It?

In this video, Dr. Jay K. Harness explains what exactly lymphovascular invasion is and why it is not a good finding.




Jay K. Harness, MD: As we review pathology reports in breast cancer, there are many things that we look at.  We look at the characteristics of the tumor itself, its receptor positivity, its degree of differentiation, and a variety of other things that I have talked about here at Breast Cancer Answers but an unusual thing that we do look for is a thing called lymphovascular invasion.  Lots of fancy words but if we break it down into its component parts, I think you will understand it, “lymph meaning lymphatic channels, vascular meaning that it can also be in things like veins, invasion.”

So if you can picture little tubes running through the breast of either lymphatic channels or veins, when the pathologist looks at the slides and cross-section, the pathologist may actually see cancer cells within either lymphatic or venous channels and that is called lymphovascular invasion.

It is not a good finding.  It is more aggressive finding if you will and you heard me talked repeatedly here that breast cancer is a galaxy of diseases so, the finding of lymphovascular invasion is one that not only means good surgical treatment typically chemotherapy but also radiation therapy.  In another words, multimodality treatment, surgery, chemotherapy, radiation therapy and even with a mastectomy or someone has been found to have lymphovascular invasion, again all of these things are necessary particularly the radiation therapy.

Another sort of aspect of this problem is if the cancer has gone in to a lymph node, growing inside the lymph node and then growing out through the walls of the lymph node that is called extranodal extension.  Extra outside, nodal lymph node, extension a finding of extranodal extension in general no matter what the other treatments are is typically an indication for adjunctive radiation therapy.

As always particularly if these kind of findings come up, please make sure that you are working with the multidisciplinary team that understands the importance of lymphovascular invasion and how best to treat it.


Dr. Jay K. Harness is a board certified surgeon currently treating patients at St. Joesph Hospital in Orange, CA. Dr. Harness specializes in complete breast health, breast cancer surgery, oncoplastic reconstruction, genetic screening, management of breast health issues, risk assessment and counseling. Dr. Harness is the medical director for Breast Cancer, and guides this first ever social media show’s information by drawing on his former leadership experience as the President of the American Society of Breast Surgeons and Breast Surgery International. Dr. Harness graduated from the University of Michigan, Ann Arbor in 1969 and spent time early on in his career at the University of Michigan Medical Center.
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