PASH diagnosis with CANCER symptoms?! CONFUSED.

Hello all,

I had a core needle biopsy on June 11th, It was a vaccuum assisted MRI biopsy. It went well, other than severe bleeding afterwards that resulted in needing it cauterized. No bruising (other than slight yellowish bruising). It went well. No pain what-so-ever. I highly recommend an MRI core needle biopsy to those who have VERY dense breasts and a high risk of cancer without their palpable lump/mass showing up on Mammos and ultrasounds! I am very happy that I had this kind of core needle done, after having a few ultrasound and hand-guided core needle biopsies in the past 2 years which resulted horribly (loads of bruising and pain).

My concern is this: I got my pathology results and I was diagnosed with PASH- that's EXCELLENT!! I had a cancer diagnosis encapsuled inside the lump previously, and luckily, thank GOD it was fully removed and not opened up to expose the cancerous cells to the rest of my breast tissue. It was taken out and on THAT pathology report I had PASH along with the encapsuled cancer.

My PASH (pseudoangiomatous stromal hyperplasia~ a rare, benign tumor in the breast that may enlarge over time) was "WHITE-GRAY & RUBBERY".......That was in 2011.......I just got my pathology results THIS TIME and read that the mass they took samples of was "YELLOW TAN & FIBROFATTY" Tissue?!?! On the new MRIs (both of them from May & June) I saw that I had "Type 1 Predominant progressive enhancement with smaller areas of TYPE 2 Plateau & TYPE 3 Rapid Washout Kinetics" It also grew SIGNIFICANTLY within a month time...NOT similar to PASH, neither was the COLOR this time........Here is some information about what I just typed- so that you can understand what these crazy medical words mean, lol- about the "enhancements, Plateau, rapid kinetics, etc"

Following administration of Gadolinium there can be three possible enhancement kinetic curves for a lesion on breast MRI. These are sometimes termed the Kuhl enhancement curves.

• type I curve : progressive enhancement pattern
  • typically shows a continuous increase in signal intensity throughout time
  • usually considered benign with only a small proportion of (~ 9%) of malignant lesions having this pattern
• type II curve : plateau pattern
  • initial uptake followed by the plateau phase towards the latter part of the study
  • considered concerning for malignancy
• type III curve : washout pattern
  • has a relatively rapid uptake shows reduction in enhancement towards the latter part of the study
  • considered strongly suggestive of malignancy

My concerns are this: since the core needle biopsy in June (almost 4 weeks ago) I have healed nicely, NO pain, nothing wrong. I HAD a large indent in my breast, because they made sure to take out 10 good samples. My finger could go inside the hole where they went around in a complete circle to remove as much of the solid part of the tumor I have, but left most of the rest of the tumor....they took, bits and pieces, but since it takes up my left outer breast, and causes pain,and is growing rapidly, we decided to move ahead with Prophylactic Double Mastectomy with reconstruction (tissue expanders & then implants a few months later), due to being high density, having had a previous cancer history, and being a young (34 year old single mommy) that needs to be here for my kiddos and don't want to go in every few months for MORE testing and biopsies. This thing continues growing!! I got the biopsy, could feel the hole, GREAT! Happy woman! NO PAIN, I was over the moon excited. THEN.........I awoke last week and realized I have a larger tumor than before?!?! The hole where the large amount of breast tumor was taken is filled up and I now have the tumor spreading across my entire top of my breast?!

I called the breast surgeon from my cancer center today and he got me in immediately (Love him. I couldn't be in better hands, he's amazing). I went in, and I am GLAD I did. I have VERY red skin on the outer side of my breast (more towards the lower part).....Not normal! He said "it COULD be a bacterial infection that's starting NOW?" So he marked the redness patch with surgical marker and told me to take pictures each day until the 5 days is up on KEFLEX he prescribed for me. He told me IF the redness goes outside the borders of that marker, to call him and get back in. I didn't know I had redness, I've noticed pain again, that lurking pain that bothers me finally came back and moving around my breast in a circle-like pattern now coming from around the side of my outer breast to the top of my breast. That's all within 4 weeks. But my surgeon was the one who turned the lamp on and noticed the VERY red lower part of my breast. Another sign that scares the shinanigans out of me, because I know that is yet ANOTHER symptom of cancer....My first time I just had ONE rock solid mass, pain, and they simply thought it was PASH and took it out to find out it was indeed cancer encapsuled in the rock hard tumor. Nothing exciting to tell about, I simply took tamoxifen for over a year and went back for many check-ups just to be told YOU'RE DENSE (lol.....glad they mean my breasts, not ME personally!! LOL) I have to joke, because I am to many buckets in with tears....It's helpful to laugh to smile the pain away.

My question is: When I look up "YELLOW TAN FIBROFATTY" core needle biopsy tissue from breast- I get results stating "cancer", "DCIS" "IDC" and other things that are cancer related?! I have felt a feeling of dread, and the spot has never been touched since 2011, I have had the SAME hard lump that has just continued to grow over time, and my old surgeon didn't listen and didn't take me seriously,so I finally went to my new dr and he's great....I am concerned that they may ONLY have seen the PASH and it's covering up what's underneath? Whatever this is, it IS NOT mimicking PASH. I've had the PASH diagnosis for a few years now, with NOTHING like this ever. It doesn't ever show up on MRI's as anything suspicious, it's just sitting there, hard to see under my density....but noticeable when they inject the dye, but NOT anything like what my MRI report stated. I am concerned that they may have opened up a literal "can of cancer cells" when they opened up that section of my rock solid tumor and now it is spreading.

Has anyone ever heard of getting an "INFECTION" from a core needle biopsy 4 weeks later?!

I have been absolutely FINE, and now this past week and a half noticed all of the above with the rapidly spreading mass coming back and larger than before, with redness all over my side of my breast now. :-/ Grrr, Can't wait to get the prior authorization all set up so that I can just go ahead with the Prophylactic Double Mastectomy and Reconstruction.....I hope this bad nagging feeling that I just can't shake is just all in my head and I can just look back and laugh at how I was so over-critical over this time that SHOULD be a HAPPY time since I have BENIGN breast condition! I should be HAPPY, but the pathology and MRI results just don't add up, along with my sudden rapid symptoms......Just makes me cringe. I pray this is NOTHING, and in a week the redness goes away, I pray this is just a freak thing and I can be onto my next step to be proactive in my life.

Bless you all as you wait for results and go through this trying time. (((((((((HUGS))))))))

Marie June