Would you consider lymphovascular invasion at the margin to be a positive margin in breast cancer surgery?
Would you recommend re-excision or proceed to adjuvant therapy if the tissue margin is negative? Pathologist states that tumor foci at margin was only identified in the form of LVSI.
2 Answers
Mednet MemberInvited Expert
Radiation Oncology · Varian Medical Systems/Allegheny health network
Answered on
LVI is an independent risk factor for local relapse despite adequate treatment. That being said, we don’t chase LVI to get negative margin as it is non contiguous involvement and not contiguous process which warrants any reexcision.
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Mednet MemberInvited Expert
Surgical Oncology · Virginia Commonwealth University School of Medicine
Answered on
There is no evidence to support LVI as a positive margin. One must presume that if you have LVI, that supports a systemic spread of disease, not local (increased risk for positive nodes, etc.). I would not re-excise for LVI at a margin.
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