First Mammogram - PASH

KMWI

Hi all,

I'm 42 and just had my first mammogram less than a month ago. Since then, I did a follow-up mammogram, sonogram, and sonogram-guided biopsy. I received a call from a surgeon about my biopsy results today - PASH. He said that he recommended that the PASH be excised, and wanted me to call back tomorrow to make an appointment for the surgery in the next month. I was a bit stunned, so didn't ask much other than surgery recovery stuff - I didn't really know what to even ask.

This all feels fast, though I have nothing to compare it to. I've had no pain/discomfort/symptoms of any kind. Although the surgeon said he could maybe feel something through a physical exam, he also said there are other area of differing thickness that feel more distinct (and aren't anything concerning based on my scans), so it's not an obvious lump. And since this is my first mammogram, there's no evidence that it's growing yet, since there's nothing to compare it to.

He's not my regular doctor, but is a general surgeon that I was referred to by my doctor's office when it was decided that I needed a biopsy. I don't have a gynecologist at the moment (mine dropped me when he decided to specialize and I'm waiting for an opening in my new gynocologist's schedule for my first appointment). I do have a GP, so thought I could make an appointment to talk to her about it, but since I've read PATH is rare, I'm not sure if she'll be familiar with it. I also don't live in a community with any doctors who specialize in breast cancer. Since it's not breast cancer, I don't even know if that's who I should talk to about this.

So...any recommendations? Should I try and get in touch with my new gynecologist's office to see if I can meet her to talk about these results and the plan to have it removed before I schedule surgery? Should I meet with my GP about it before deciding on surgery? Is surgery just the right option for PATH? Is there something I should call back and ask the surgeon about to help me feel more confident that surgery is the right option?

I don't have a history with any of these medical professionals and I've never had more than a wisdom tooth removed, so these are probably combining to make me more nervous about all this. I also found a few sources that said surgery isn't necessarily recommend for PATH, but I'm not familiar with the sources or PATH, so don't know how to evaluate this information very well or determine how it relates to me, since I've not received any written documentation or records, so I know nothing other than PATH was found.

I've been reading through other peoples' posts on PASH, but many seem to either notice a lump, notice it's changing in size, or have other symptoms (pain, etc.). I'm not having any of that - is surgery still likely to be a obvious choice?

Moderators

Hi there, KMWI! We're so sorry you're experiencing this worry, we know it can be a lot to process. It's always a good idea to get a second opinion, especially if you're unsure about the proposed treatment plan or are unfamiliar with the medical team. Surgery is common if the mass is large or causing you discomfort, but some women opt to take a wait and see approach. In any case, it's important that you have all the information you need and fully understand your diagnosis before making any treatment decisions. We encourage you to discuss the diagnosis with your new gynecologist, and before scheduling your surgery, request an appointment with the surgeon to go over all of your questions!

Please keep us posted on what you decide!

The Mods

KMWI

Thanks for the response and good recommendations. I was so startled by the news, I think I need to sit down for a bit more reading and to write out a list of questions so that I'm sure I don't forget anything. Meeting in person with the surgeon to talk through my questions and the reasoning behind his recommendation, as well as a second opinion/consult with my gynecologist to go over the results sound like a solid plan.

SmallTownGal

Hi Kiwi,

So sorry you're going through all this, especially after your very first mammogram!

I don't have much to add to the moderators excellent advice, but I can say this: Throughout my adult life, I've always opted for getting as much information as reasonably possible before any major decision and it has stood me in good stead for many years now.

I have a friend who traveled to another US state for her breast cancer treatment. She was lucky enough to have family close to one of the premier world treatment facilities and was able to stay with them for the duration of her treatment. It gave her a lot of comfort to be treated at a place she felt was the very best. I mention this because you say you live in an area without breast health specialists. Would it make you more comfortable to travel a bit in order to see a breast specialist?

Chemistry91

PASH is rare and doctors tend to use a wait and see approach with it. I would definitely get a second opinion from a breast specialist before surgery. If traveling is not an option, try the Cleveland Clinics online radiology services.