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Sunday, January 23, 2011 sanorita, Community Member, asks

Q: angiolymphatic invasion

what does angiolymphatic invasion mean? my mom has been diagnosed with stage 2 IDC, she had mastectomy and her path report: with margins clear but with angiolymphatic invasion, no nodes involved, ER/PR is (2/8) neg and HER2 is (2%) weakly positive... 

How can angiolymphatic invasion happen when no node are involved. or can we say that angiolymphatic invasion was within her breast and as she has been done with mastectomy,  So she is safe. she does not want to take up chemo....?

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Answers (1)
Phyllis Johnson, Health Guide
1/23/11 6:23pm

Angiolymphatic invasion means that cancer was found in the blood vessels and lymph vessels.  Since your mother didn't have any positive lymph nodes, it sounds like the cancer may not have spread beyond the breast.  There is no way to know for certain.  The lymph vessels in the breast are connected to the body's entire lymphatic system.  We also have lymph nodes in other areas near the breast like under the breast bone and near the collar bone.  Most of the lymph vessels in the breast drain to the lymph nodes under the arm, and the nodes under the arm are the easiest to sample.  

There is never a guarantee that cancer has not left the breast even when the margins appear clear and the nodes are negative.  The surgeons have some good clues that they "got it all."  When they are not sure, they like to recommend a systemic treatment like chemo which reaches every part of the body.  They hope to kill any escaping cells that way.  

Your mother's doctors can give her their best guess about whether she needs chemo.  Then she can decide what she wants to do.  If your mother is resisting chemo because she has heard horror stories about the chemo side effects, she needs to know that new medications do a much better job of managing side effects.  Some women breeze right through; most people have a few, but not all, of the possible side effects.  If she starts chemo and decides it is too hard, she can discontinue it.  


sanorita, Community Member
1/24/11 12:40pm

thank you Phyllis, but do u have any idea where the cancer cells move  first : to the lymph vessels or the blood vessels. my mom is only worried about one big side effect of chemo and that is losing her hair which is one of the side effects that she does not want....and if u would say wigs are available now a days, i Would like to know if the wig would give a person a similar appearance as they were before chemo or will it give a fake appearance??

can we leave her without chemo because she totally depressed???


Phyllis Johnson, Health Guide
1/24/11 7:33pm

I don't know if there is a usual pattern to whether cancer cells get in the blood stream before the lymph vessels or vice versa.  I don't think it makes a difference in terms of chance of recurrence.  A recent study found that even one circulating tumor cell in the blood stream increases the chance of recurrence.  We also know that cancer in the lymphatic system can be dangerous.  Of course, there are people who have a high chance of recurrence who stay well without extra treatment.  Most people, however, choose to do what ever they can to increase their chances of staying well.

No one likes losing her hair.  I have a distant relative by marriage who decided that she would rather die than lose her hair; so far she is still alive although frail.

There are beautiful, reasonably priced wigs these days that look very natural.  People told me that they didn't even realize that I was wearing a wig.  A counselor and/or medication might be able to help your mom with her depression.  I don't know how old she is or how many life goals she still wants to accomplish.  If she has been brought up to believe that cancer is a death sentence, she may be feeling that she would lose her hair and still die of cancer.  Has her doctor given her all the risks and benefits of doing chemo versus not doing chemo?  

sanorita, Community Member
1/25/11 1:38pm

Thank you Phyllis. i have fixed an appointment with the medical oncologist, just need to know what he says... 

leeann56, Community Member
2/28/11 5:09pm

Tell your mom to google cold caps. You do not lose your hair on chemo. They really work!!!

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By sanorita, Community Member— Last Modified: 02/28/11, First Published: 01/23/11