PASH - Pseudoangiomatous stromal hyperplasia

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  • vollmer621
    vollmer621 Member Posts: 4
    edited April 2013

    My bs is concerned because I have a family history of breast cancer, my sister and aunt had it.  It has also been growing, therefore, she feels it's a necessary to take it out. 

  • marie5890
    marie5890 Member Posts: 3,594
    edited April 2013

    If PASH grows, it should be taken out. Not that it turns malignant. It doesnt. But it obstruct the view of areas that are problematic. Vollmer, your BS is wise considering all the factors of yours

  • tpachris
    tpachris Member Posts: 2
    edited May 2013

    Hello, 

     Four years ago while pg I had an u/s for a lump in my left breast. Nothing was found, no mammo due to pg. In March of this year my gyn felt the lump had grown so I had a mammo and u/s. The lump is painful part during part of my cycle. The mammo found calcifications that required a needle biopsy. I received the results of that this week. I was dx with PASH. I need to f/u with BS to determine if it should be removed. 

     I am currently on Mirena and was on the pill for 6 years in the past.

     I would like to know what the scar is like from anyone that has had it removed. TY

  • cinnamonsmiles
    cinnamonsmiles Member Posts: 779
    edited May 2013

    Hi, I had PASH in the breast opposite of my cancer. It wasn't caught by a mammogram, it was caught on a presurgical MRI for breast cancer. My surgeon had it done before my mastectomy.

    Like anything in the breast, cancerous or not, no one's scar is the same. I imagine the scar will depend on WHERE the PASH is located (deeper in the breast, near the skin, etc) and the size of the PASH. 

    I ended up having a lumpectomy for cancer, which the scar wasn't too big, considering the size of material that needed to come out. I didn't know it was PASH in the other breast until I had the double mastectomy. I decided NOT to go through all the biopsies, lumpectomies. Since I was already having one breast removed, I just elected to have the other removed. But my case was different since I already had a cancer diagnoses.

    I would ask your surgeon. We really can't tell you because we don't know how large it, where it is located, etc. Even if we did, that is something one just can't answer on a discussion board. Too many variables.

  • tpachris
    tpachris Member Posts: 2
    edited May 2013

    I found a lot of very helpful info here: http://www.breast-cancer.ca/type/pseudoangiomatous-stromal-breast-hyperplasia.htm

    Mine is scattered so I really need to have a conversation with my surgeon before scheduling.  His nurse left it up to me to schedule surgery if it was bothering me. 

  • spanky
    spanky Member Posts: 5
    edited July 2013

    hi, I had my pash removed 4 months ago and already the scar has healed quickly. You wouldnt know it was there unless you were looking for it.

  • spanky
    spanky Member Posts: 5
    edited July 2013

    I had my pash removed 4 months ago, and it has grown back. I am on hormone replacement theraphy to try to make it go away. Has snyone else used this as treatment?? It is very painful.

  • marie5890
    marie5890 Member Posts: 3,594
    edited July 2013

    Spanky, I have never heard of using HRT to try and get rid of PASH. Have your tried a second opinion?

  • spanky
    spanky Member Posts: 5
    edited July 2013

    it's been nearly a week and no change, Will be contacting the dr tomorrow and find out if treatment will continue. In so much pain from it.

  • Babyloc3
    Babyloc3 Member Posts: 1
    edited July 2013

    My SON was diagnosed with PASH 2 years ago (at 12 years old) after finding a lump in his left breast with a hemangioma which were removed.  He was doing well until this week when he has just now found a painful lump on the other (right) breast.  The first lump was not painful and we only found it because he began to bleed from his nipple secondary to the hemangioma.  I am concerned now because this second lump is very painful and it appears to be a reoccurance of the PASH? on the OPPOSITE side.  Has anyone (MALE) had this type of experience or had a teenager with anything like this?  Just looking for some advise or comiseration.  He goes beck to the breast specialist next week, but I remain concerned :(

  • Moderators
    Moderators Member Posts: 25,912
    edited July 2013

    Hi Babyloc3. Welcome to BCO. We are sorry about your son and all you are going through, although we are glad you found this great community for information and support.

    As a recommendation, you may be interested in checking out also the Male Breast Cancer forum.

    Hope this helps.

    ---The Mods

  • sandyoz
    sandyoz Member Posts: 1
    edited July 2013

    Hi everyone my first post here .. I discovered a lump December 2012 had to wait two months to see BS he did a FNA had to wait a week for results said it wasnt cancer but to come back in 3 months my lump had got bigger during this time so i had a core biopsy said it was Benign come back in a year. Had another mammo and ultrasound a year later March 2013 lump increased in size saw BS again had lumpectomy on 30th April diagnosed with PASH.. having followup baseline mammo and Ultrasound next month. Lump was 5cm occasionally a bit painful. I asked questions including will it come back he said no.. did he get it all he said yes..despite this I still have a lump in the same position. Is it normal to still have a lump after lumpectomy? BS said i dont need to see him again unless i feel i need to he said the first mammo i have will show what appears to be a breast tumor he said this is normal? My incision scar is slightly raised also wondering if that is what usually happens? Hope someone can advise me ..thanks Smile

  • michellec15
    michellec15 Member Posts: 1
    edited September 2013

    Hi all. I have been diagnosed with PASH and my doctor wants it removed.  I know the reason is that my mother passed and she had breast cancer which metastasized.  At first, I was really concerned but after reading the posts I'm a little hopeful.  I was hoping it will go away.  Now I know for sure that's a possibility since people have had that to happen.  I am reassured that it is benign which she told me as well but I was thinking that I had to have surgery.  I don't want to go against her advice but the idea of surgery makes me nervous.  Has anyone had the surgery?  She stated that since I have a large bust, there may not be much notice but there is a possibility.  Does anyone know what the chances are of one breast being very different than the other or scarring? I have concerns about others forming if I have this one removed.

    Thanks,

  • irenebru62
    irenebru62 Member Posts: 8
    edited September 2013

    Hi there, I was dx with pash in March of 2013. I am scheduled for my 6 month mamogram next Tuesday and a little nervous. once you get that b9 result you think wow its over and then they say, see you in 6 months, yuck. I have had some soreness in the affected breast and that concerns me. I had a stereotactic biopsy which was benign and a BSGI which was negative so you think I could just relax. My surgeon does not usually excise pash but said if it is bothering me he will. Has anyone one else had tenderness with pash.Can it grow during the 6 month wait for the follow up mamo. I certainly hope the biopsy was read correctly, had it done at a very well known breast center, I guess the worry never ends. Trying to be positive...

  • marie5890
    marie5890 Member Posts: 3,594
    edited September 2013

    Hi ladies and welcome.

    Normal protocal is to remove PASH, but it's not the only option.

    Can PASH grow? Yes.

    Can it go away on it's own? Yes to that too.

    I had PASH and chose not to have it removed as it was not bothering me, and mine did go away.

    Monitoring it to see if it grows is a reasonable path if one choses. Or having it removed, if one choses. Sometimes it does continue to grow where it causes pain, and in that instance it is usually removed. 

    Michelle, how large is your lesion? If it is small, removal wont make a marked difference. If it is larger, then yes it can. 

    With PASH,  you dont have to make a decision "right now". 

  • irenebru62
    irenebru62 Member Posts: 8
    edited September 2013

    Hi there, just was wondering if anyone did have any discomfort with pash. I ask because this has been a long road for me, started out in a local breast center and lests just say it was not a pleseant experience. Decided to go to a breast surgeon and he just wanted me to wait 6 months to see if the area grew larger, I opted for a biopsy. As I stated earlier I also had Breast Specific Gamma Imaging which was negative and the surgeon felt the biopsy would be negative which it was. I guess the discomfort I have is intermittent and probably would ot even notice it if I wasnt scheduled for this post mamogram. I am quite certain anxiety plays a role in all of this but curious to see if anyone has experienced any discomfort or gone on to have a different diagnosis...Thanks

  • mysarojane
    mysarojane Member Posts: 7
    edited September 2013

    Can PASH occur in the area between the breasts? Has anyone had this happen?

  • Grace1969
    Grace1969 Member Posts: 26
    edited September 2013

    My pash is 1.2 cm. I went to the BS today and I'm scheduled to have it removed October 3...I'm nervous, afraid and don't know if this is the right decision.

  • Grace1969
    Grace1969 Member Posts: 26
    edited September 2013

    Mysarojan, I don't know.

  • maiyen
    maiyen Member Posts: 81
    edited September 2013

    Hi all,

    Just wanted to say that my initial biopsy came back as PASH and yes, I often feel discomfort in that breast.  It is intermittent pain and does not seem to be cyclical, but varies between sharp, zingy, achy, and 'pinchy' pain.  PASH can grow and how fast it might grow can vary (rare tumoral PASH seems to grow quite fast and can get very large). 

    I am actually having my mass removed at the recommendation of my surgical oncologist.  There has been some growth, and although not by a large amount, my mass is already 5 cm so we don't really want to sit around and have to take out even more tissue if it does keep growing.  Plus I am feeling the pain/discomfort.

    Take care. 

  • Grace1969
    Grace1969 Member Posts: 26
    edited September 2013

    Maiyen, I was suppose to wait and see, but I just couldn't. I wanted it out before it became larger. I'm going to a general surgeon that specialize in breast. All of the Drs seem calm and cool, like its really not a big deal. Maybe I've frighten myself by researching too much about PASH:-) Anyway, Agnes (the name I've given my PASH tumor...lol) will be removed October 3. Keep us update.

  • maiyen
    maiyen Member Posts: 81
    edited September 2013

    Grace,

    I will keep you posted...hope you do the same :)  I think you have to do what is best for you, and I certainly understand how these follow ups don't help the anxiety.  

    Agnes...LOL  I started calling mine The Angry Boob because it always seemed to be grumpy and cause pain.  Now with surgery coming up, Angry Boob is being called by its new name, Frankenboob (not to offend anybody who has had any type of breast surgery).  I'm just trying to lighten up my mood and for some reason giving it a goofy name helps some.

  • Grace1969
    Grace1969 Member Posts: 26
    edited September 2013

    Maiyen, I had an ovarian cyst removed three years ago and I called him Virgil...Yup, the Drs made an incision on what's suppose to be my bikini line, and removed the cyst. I always tell folks, I gave birth to Virgil, by Cesarean section...lol



    I'm ready, I think. I pray the PASH doesn't come back and there's no complications with the surgery.

  • Grace1969
    Grace1969 Member Posts: 26
    edited September 2013

    I was going over my paperwork for my surgery to remove my PASH on October 3. I noticed the Dr is sending me to radiology, to have some type of wire inserted to mark the lump, prior to surgery. Will I be numb for that? Is it painful?



    Also, I will be under general anesthesia for the tumor removal, but the Dr asked if I wanted a block administered before I'm knocked out, to help with the pain once I come to. Any insight? Should I get the block? Has anyone else gone through a simililar scenario?

  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited September 2013

    Grace, when I had the wire localization I was more uncomfortable from holding my head & hair back and out of the way in an awkward position then from the procedure. It is like having a long seated mammogram. They numb you before, so it isn't bad.



    They took a golfball size chunk with my excisional & I really had minimal pain afterward & that pretty well seems to be the experience of most women who comment here. I argued with the nurse in recovery that I didn't WANT to take a pain pill because I was afraid it would make me carsick on the way home. I filled my pain prescription and only ended up taking a couple. Aleve was plenty after that. The ice pack helped more than the meds.

  • elyse13
    elyse13 Member Posts: 4
    edited September 2013

    Hi -

    I was diagnosed with a PASH a month ago.  My surgeon prefers to wait and see rather than automatically do surgery.  I have to go back in six months for another ultrasound.  I am afraid it is growing, so I may have to go back earlier.  I have small breasts made worse by two pregnancies and breastfeeding.  My surgeon did say if I do have surgery, it will probably be a notable difference between them.  My question is, did anyone do the surgery and have implants placed at the same time by a reconstructive plastic surgeon?  I never thought I would want them, but they are already quite sad looking after breastfeeding and I can't imagine them now being quite uneven.  My surgeon said it is an option since it is noncancerous and I won't need chemo/radiation.  Any thoughts?  I spoke with the radiologist in depth about implants "hiding" breast cancer and what not, and I was quite comfortable with that part.  Thanks

  • EJgirl
    EJgirl Member Posts: 5
    edited October 2013

    hi, grace...i have been reading your posts and wonder how you are doing. i was diagnosed with breast cancer in july and still going through chemo. Been thinking about you and how you are coping. Let me know! 

  • Grace1969
    Grace1969 Member Posts: 26
    edited October 2013


    EJgirl, it's been a rough week! I had my PASH removed October 3, under general anesthesia, as an out patient. The evening of October 4, I noticed increased pain, swelling, dizziness and redness extending from my breast, up my chest to my neck. Went the the hospital's ER, that perform my wide local excision and was immediately admitted, rushed back to surgery, due to internal bleeding. There was 400 CCs of blood sitting in my breast and I lost another 100 CCs during surgery. My hemoglobin level dropped to 7.8. I stayed in the hospital for two days. I'm doing better, still fatigue and emotional. I didn't receive any drains during the first or second operation. I'm a little concern now, because I can hear fluid swishing around in the breast. Is that normal? No pressure, no pain and a little swelling.

  • gigi7447
    gigi7447 Member Posts: 1
    edited October 2013


    hi gigi7447


    I just had surgery and found out i had pash it was nice reading all your stories

  • anasamara28
    anasamara28 Member Posts: 2
    edited October 2013


    Hi all,


    I was diagnosed with PASH December 2011 (18yrsold) and was given the options of surgery to remove or wait and see. I didn't want an invasive procedure at the time so opted for the wait and see method. I did some travelling for most of 2012 and when I returned in March 2013 had another ultrasound which showed that the PASH had grown. The previous largest dimension was 3.9cm and the new largest dimension was 4.7cm. I was still told there was no need to panic and put it out of my head as there was no pain and I was also heading back overseas for another few months. In the last month or so I have been doing my own research as I was getting a bit suspicious of the lump and was sure it was still growing. I am arranging to see a specialist in Brisbane in the next couple weeks and just wanted to know if anybody had any advice on my case.

    From what I can see, everyone is unique and what worked for somebody may not work for another. Having said that, Is it unusual or bad that I left it until now to potentially remove it? I have been reading lots of stories about it growing and deforming the breasts (I am an E cup) and other cases of PASH returning after removal. I sort of feel that the severity of the situation wasn't explained to me when I was first diagnosed and had I know that it could create a dramatic cosmetic difference I probably would have got it out sooner. Any advice at all or your own experience would be greatly appreciated! I'm stuck between a rock and a hard place of leaving it to it's own devices, Paying up-front for surgery in Australia or waiting another 3 months til I return to NZ and then removing it if need be.



    -Ana

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