Hi. My aunt was diagnosed with a stage 3 micro-papilloma cancer on her chest wall behind her left breast in 2010. After 2 separate rounds of chemo, a lumpectomy and a double round of radiation she finished treatment at the very end of 2010. She is still, after 3 years recovering from the chemo. Her hair all over her body is still not growing back very well, she cannot get her weight down, her liver values are still not very good at all and her thyroid is underactive.

We've just been advised late last week that the cancer is back. They are calling it a recurrent cancer, this time as Inflammatory Breast Cancer with lymphovascular invasion. We're waiting the results of the bonescan and CT scan to confirm whether it has spread and for her to be re-staged.

The cancer is a ductal carcinoma of 6cmx3cmx6cm and is poorly differentiated (on her left breast again). For the past 7 months she has been dealing with a nasty abcess on her breast and inflammation, pain etc - all of the markers that we now know as IBC but at the time, we assumed were just part of this 'infection' the Doctor's that she saw kept blaming it on. (She was unfortunately, consistently mis-diagnosed by several GP's throughout this year, it wasn't until she saw her original surgeon for a standard yearly checkup that he correctly diagnosed it.)

I'm worried absolutely sick that she's going to get re-staged into a terminal/palliative stage and that the cancer has spread past her breast. With her last lumpectomy in 2010 they removed 11 nodes from her left armpit and 2 of those then were cancerous. (Her right breast however, was then and still is now - completely clear.)

How can she have lymphovascular invasion if there aren't any nodes left in her left armpit?

Also - in the last week or so she is starting to get these red lines (much like what blood poisoning can look like?) as though she has infected veins - running down from the underside of the left breast about 2.5" long heading downward on her ribcage. Is this the cancer spreading? There are about 3-4 of them currently.

I have included below, word for word, what the test results from pathology on her 3 x core biopsies last week stated:
'The sections of the breast cores shows fibro fatty tissue with fat necrosis. There is, however, nests and single tumor cells which are cytokeratin positive consistent with recurrent ductal carcinoma. Focally there is a focus suspicious for lymphovascular invasion. Sections of the skin core show ulceration, deep to which there is infiltration by nests of poorly differentiated carcinoma. The features would be in keeping of recurrent breast carcinoma.
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Can you please help me to understand this and also help me with my questions about the lymphovascular invasion, those odd red lines moving down her body under the curve of her breast and also can you please help me to understand - if this cancer has spread, where is it most likely to spread to first?

I'm very very appreciative of your help,

Sarah