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Biopsy showed PASH

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  • Carrissac
    Carrissac Member Posts: 1
    edited December 2017

    Im happy to see others have had this diagnosis of pash, my radiologist that saw me today had no idea what I was telling him when I explained I had a pash tumor removed two years ago. Developed bad pain in my chest nine months ago that started to throb and came and went kind of when my hormones we're up. Today I had another mammogram and ultrasound and they said there were two lumps one by my old incision area on the armpit side of my left breast and one pea size near my nipple. I have doing nothing but crying most of the day with no definitive explanation as the radiologist just didn't know what it was by the looks. Says that "typically". He can tell if it's malignant but didn't know what mine was. Just panicking I'm only 37 I'd rather have it be another pash mass but who knows what it is

  • chemistry91
    chemistry91 Member Posts: 12
    edited December 2017

    Carrissac,

    PASH does tend to puzzle radiologists who don’t see it very frequently. Do you go to a breast specialty center? I know my small town radiologist was freaked out by my PASH, but when I was referred to the Cleveland Clinic they new right away what it was.

    Can you get a second opinion from another provider? I know Cleveland Clinic has a program online where you can submit scans for a second opinion.

    Also PASH does tend to be painful, and there is research that it is hormone driven. So your symptoms tend to correlate with PASH.

  • Shortygirl
    Shortygirl Member Posts: 5
    edited December 2017

    Hi Chemistry91. How is your recovery going? They have never mentioned a "partial mastectomy" to me. I didn't even know that can be an option. I will have to research that and educate myself. I hope you are doing well with your recovery. Carrissac, I agree with Chemistry91that you would benefit from a second opinion. I drive 2 hours to see a breast specialist and it is worth it. Hopefully you can find a more specialized physician in your area who has some experience with PASH. It definitely can confuse a radiologist who is not very familiar with it. I hope you are able to get better answers soon. I know the waiting and not knowing can be hard.

  • marie5890
    marie5890 Member Posts: 111
    edited December 2017

    Just wanted to share my experience with PASH, which I was Dx-ed with back in 2010. I chose not to do anything about it and monitor it, as sometimes it goes away on it's own, which was what mine did.

    Odd thing, PASH

  • DailyZey
    DailyZey Member Posts: 2
    edited December 2017

    Hi marie5890,

    How did your PASH tumor go away? Did you do anything different? lose weight, exercise, eat differently? I'm just curious, it looks like some PASH grows bigger and some disappears on its own.

    thank you in advance for your response,



  • marie5890
    marie5890 Member Posts: 111
    edited December 2017

    Nope, didn't do anything different as far as life style. It just went away. :)

    Definitely monitor it, because if it does get bigger, the concern is that it may hide other areas, so you may want to get it removed.

    Don't panic. It's not dangerous.

  • chemistry91
    chemistry91 Member Posts: 12
    edited December 2017

    I am doing pretty well. Thanks for asking! Still really sore but they tell me this is normal because of how much tissue they had to take from my left breast.

    My PASH had gotten significantly larger, from about 2 cm in length to 7 cm so it was time for it to come out.

    They told me it doesn’t increase my risk for breast cancer and they are unsure of the cause. They did say that PASH in tumor form like I had is quite rare. Reading the pathology report was interesting because there was definitely a mass there and it was different in color and density than the surrounding tissue.

    I have a science background and have tried to research PASH but it is so difficult to find recent sources. My doctor co-authored a paper but even that was written in 2014.

    I was unaware that PASH can disappear on its own. I am curious about that and hope I didn’t make the wrong decision in having it removed. Hoping it doesn’t come back because I am nervous about how they would treat it.

  • marie5890
    marie5890 Member Posts: 111
    edited December 2017

    Chem,

    Considering how much yours grew over the past few years, removing it was the right thing to do. You made the right choice.

  • Shortygirl
    Shortygirl Member Posts: 5
    edited December 2017

    I agree that having it removed was the right choice in your case. It's so crazy that they don't know what causes it and it can be so different from one person to the next. I tried to research it also when I was first diagnosed to try to educate myself, but there is so little out there. I need to request the pathology report from my last surgery, I'm curious about it. I have been told that if I keep needing surgeries that eventually I may need acomplete mastectomy. I hope it doesn't come to that.

  • DailyZey
    DailyZey Member Posts: 2
    edited December 2017

    Shortygirl - I also read that it can come back and a complete mastectomy might be required. So very strange... Well at least it's definitely benign although it does cause some pain for me during ovulation.

    Let me know what you find out from your pathology report!

  • Thunderstruck
    Thunderstruck Member Posts: 7
    edited July 2018

    Chemistry glad everything went well for you. I think you did the right thing by having your PASH tumor removed. I also had a PASH tumor and after having it removed ADH was found inside of the tumor. My breast surgeon said she’s glad we removed it.


  • ml8
    ml8 Member Posts: 1
    edited October 2018

    Hey, I'm in a similar situation right now. What did you end up doing?

  • Shortygirl
    Shortygirl Member Posts: 5
    edited October 2018

    Hi ml8. I'm not sure if you were asking a specific person...but in my case I just continue to see a specialist every six months. I have not had another mass so far, so no more surgey. I haven't had any pain the last few months, so I hope this is a good sign that it is slowing down. I hope you find a good doctor and get some answers. It can be very frustrating and confusing at times. I wish you the best.

  • Mdjo
    Mdjo Member Posts: 1
    edited November 2018

    I just got diagnosed with PASH the radiologist called me and said to just continue with the Norman annual memogram, that was it! I didn’t get a call from my Dr or anything, I thought it was weird as I see here most of you been asked to do memogram twice a year and have heard from your Doctor, what should I do?

  • moderators
    moderators Posts: 7,884
    edited November 2018

    Hi Mdjo, and welcome to Breastcancer.org!

    If you have concerns about your PASH diagnosis, and if it would make you feel better, we'd suggest calling your GP and asking if he/she agrees with the radiologist's follow-up screening plan. To hear it from a second medical professional may make you feel better about keeping close tabs on your situation.

    We hope this helps!

    --The Mods

  • Shortygirl
    Shortygirl Member Posts: 5
    edited November 2018

    Hi Mdjo. I would say follow up with the doctor that sent you for the mammo. I do see a doctor every six months for mine, but I only get a mammogram once a year. Most insurances will only pay for one mammogram a year. When I started going regularly for checks I already had a palpable mass which needed to be removed. PASH is one of those strange cases that can be so different from one person to the next, therefore the treatment and monitoring can vary a lot. Also, it wouldn’t hurt to get a second opinion if you are concerned.

  • SuperM
    SuperM Member Posts: 1
    edited January 2019

    Did you get genetic screening?  Do you have any close relatives who had breast cancer? Do you have dense breast tissue? All of these factors affect how closely you should screen and what you might consider doing.   I have PASH, I have CHK2 gene mutation and my mom had breast cancer when she was 40.  I also have extremely dense breasts which makes it hard to find cancer during screening.  I went to three doctors.  One doctor told me I need to get the PASH surgically removed especially since it is large (1 1/2 inches) and growing.  I also detected a lump next to it which is probably also PASH (I have an appointment for a mammogram and ultrasound next week).  That doctor suggested a prophylactic double mastectomy (I have had 5 biopsies and I am 56).  She said I will be lopsided after a lumpectomy so I might consider prophylactic double mastectomy surgery which includes reconstruction.  Two other doctors told me to just watch it (I saw them before I found the new lump).  A genetic counselor can help you quantify your chances of getting cancer compared to the normal population.  If you don't have genetic mutation, dense breasts or family history, you might consider just monitoring yearly or twice a year (I get an MRI 6 months after my mammograms + ultrasounds).

  • Romay
    Romay Member Posts: 2
    edited February 2019

    HI,

    I was diagnosed with a PASH tumor 2 years ago in my left breast. It was found in a mammogram but was palpable. I had it removed through surgical biopsy. Results came back benign. I could find so little research on this, other than it being vary rare. Two years prior to that (same breast) I had a biopsy for fibroadenomatoid "change." Also rare, although not quite as much so.

    Then this last December, they found DCIS. Same breast of course. This is all over a 5 year span,age 40-45. Clearly that breast has some odd cell growth going on and it wasn't going to stop. I opted for a full mastectomy and because it was caught early, no rad or chemo.

    I think my case is unbelievably rare and from what I understand there isn't a link between PASH and cancer. However if you have had more than one biopsy, even if benign, keep an eye on things! Best of luck to you!

  • blah333
    blah333 Member Posts: 68
    edited March 2019

    I had PASH found on biopsy with my DCIS...... I had a mastectomy and nobody mentioned it ever again. But I came across my pathology notes and seems like I was not too many degrees away from having developed invasive cancer (large span, palpable lump, some central necrosis) It makes me worry more about possible recurrences, if you add in PASH, just more weird cellular activity in my body. I was 35, also hormone positive. I go to an educational hospital and not all doctors are knowledgeable and I got "distracted" recovering from mastectomy and never brought it up again. I hope the pathologists were thorough.

  • Sasu
    Sasu Member Posts: 2
    edited March 2019
    I’m an 8 year breast cancer survivor. I had positive nodes, so had the full chemo, radiation, and the full Herceptin round, since the cancer was triple positive. I also took hormone suppressors for the five years . I am post menopausal. Now I am 63 . Fast forward to November 2018 and my mammogram showed an abnormality. After ultrasounds, mammogram, mammomri, and biopsy, it was diagnosed as PASH. On the other breast, of course. Two weeks ago,under the advice of my oncologist, they removed it. (Lumpectomy). Good news, no cancer. We’re hoping they got it all, because if it shows up again I will be going for a mastectomy. I am not even in the right age group for PASH. But then, I’m the only one in my family with a cancer diagnosis. Remember to ask those questions-write them down if you have to. The internet has little information on this disease. I found with the breast cancer there was information to be had, but there is also a lot of misinformation. As I told my children and grands....Be vigilant. Live your life. Enjoy your life. But if something on your body doesn’t seem quite right, get it checked out and demand answers.
  • ljgs
    ljgs Member Posts: 1
    edited March 2019

    Hi, ladies. I'm the concerned mother of a 22 year old who was diagnosed with PASH last year at 21. She has been on and off the pill since her mid-teens for polycystic ovary syndrome, and about a month before finding the lump she had taken the morning-after pill. I don't know if her PASH is hormone related. She saw a breast specialist over Thanksgiving and again over Xmas when she was home from college because she thinks it's getting bigger. He is urging watchful waiting. If the lump is enlarging, I fear she may need surgery--although she won't be back in NJ till late June. Right now, I plan to schedule a second opinion appointment with a specialist at Sloan Kettering here in NJ, but I'm a little scared by all the talk of mastectomy as a result of PASH. Please help put my mind at ease. There is no history of breast cancer in our immediate family, and I do not have the BRCA gene. Thanks.

  • Sasu
    Sasu Member Posts: 2
    edited March 2019
    Hi- I know some are told PASH may be hormone related. If that is true, why did I, a postmenopausal woman get it this past year? I am not so sure they know that much about it. It was recommended Ihave mine removed now, rather than wait, because if it is growing, why not remove it when it is smaller ? No surgery is fun, but a lumpectomy is much easier to recover from than a mastectomy, any day. If PASH can hide cancer, why take the chance? Obviously you are still concerned-there is nothing wrong with getting a second opinion. Best of luck to you.
  • Harms1975
    Harms1975 Member Posts: 3
    edited March 2019

    I had found a lump 2.5 years ago in my right breast and after going to my GP, I began mammograms every 6 months. After 2 years of this and feeling like I was on an emotional roller coaster, I went to a breast speciality clinic for a CESM and ultrasound. I ended up having 3 core needle biopsies in different areas. The lump that I had found came back as PASH and atypical ductal hyperplasia.

    Since the lump had grown so much over the past 2 years, I had it removed and was shocked when I went for my post op and was told I had DCIS with microinvasion component and it is ER+. Still reeling, I have my oncology appointment tomorrow and genetic counseling appt on a Wednesday.

    I don’t even know what to expect. I’ve been driving myself nutty with worry about it not being seen on any screening and of there’s more cancer hiding since I have very dense breasts with PASH in both!

  • blah333
    blah333 Member Posts: 68
    edited March 2019

    Nobody is suggesting mastectomy for PASH. Some people have had that part removed (like a lumpectomy) but your daughter probably just needs to be monitored.

    I'm not sure how hormonal it is. They found my PASH and DCIS 10 years after I stopped taking birth control. So it's probably not related to the pill/or morning after pill.

  • Vantila1
    Vantila1 Member Posts: 2
    edited March 2019

    Just diagnosed on core needle biopsy with PASH, and this is in my right breast with development over less than 8 months (exact timing between MRI screenings). I've been well-monitored since I had high-grade micropapillary DCIS in left breast less than three years ago so the doctors and I can pretty much know exactly when this PASH became noticeable on mammos and MRIs. I also have extremely dense breast tissue in both breasts. I had a lumpectomy for the left breast DCIS and then 6 weeks of whole breast radiation therapy (but no chemo, so thankful!). Now this panic because of PASH in the right breast, which the doctors thought was infiltrating ductal carcinoma.

    And all this between the ages of 41-44 (as of next month). I have a few questions specifically for those who have had a breast cancer diagnosis either before or after your PASH diagnosis:

    1. Did you have clinical symptoms? I had bloody nipple discharge with both the DCIS and now with the PASH.

    2. On core needle biopsy for PASH, my focal area was only 4 mm (mm...not cm). I'm having a lot of pain at various points during menstrual cycles. Did any of you notice sudden peau d'orange skin changes (orange peel skin) or that your PASH boob got darker in skin color? I'm white (Caucasian) and my PASH breast turns a very dark brownish color like a deep tan sometimes that doesn't seem tied to menstruation. Anyone else having weird skin color changes that last a few days and then quickly fade back to normal?

    3. Is your PASH just in one breast (unilateral) or both (bilateral)? And, if bilateral or both breasts, was the PASH present in both breasts at the same time or did one breast develop PASH later than the other breast?

    There is definitely not enough research done on this benign disease. I'm scared and angry...didn't want to be back at oncologist and surgeon offices. My oncologist and breast surgeon has given me two options thus far: 1. Wait six months and redo the mammos, ultrasound, MRI to see if anything has changed; or, 2. Another lumpectomy, also known as wide local excision, as a "just to be sure" and to help relieve some of the pain the PASH is causing. Both are not satisfactory for me. What are the qualifications for mastectomy?

    Just so frustrated with boobs!

  • Vantila1
    Vantila1 Member Posts: 2
    edited March 2019

    @Harms1975

    Big breath. I'm so sorry you're going through this. With the careful monitoring, the DCIS with microinvasion news must be a shock for you. The surgeon will remove the lump and make certain to get you good, clear margins so it will be gone hopefully forever. I sympathize with you over your worries about more cancer being missed as I too have dense breasts and PASH and have had DCIS (in contralateral breast than the PASH), but make sure your surgeon understands your complicated breast history and can assess and differentiate between cancerous lesions and lumps and PASH lesions. Also, having gone on this road before myself, you DON'T have to make a decision immediately...take a few days and think through your options and your needs, physically and emotionally, before you decide how to proceed with surgery. I panicked, made up my mind on the spot and chose a more conservative approach to the DCIS, but oh...now, oh now, I wished I had taken a bit more time to think it all through. I'd have opted for bilateral mastectomies just for the peace of mind alone. But, I didn't know then that a PASH diagnosis was going to happen then either.

    I'm sorry, Harms1975. You shall make it through this and hopefully be at peace soon.

  • Lacs93
    Lacs93 Member Posts: 1
    edited April 2019

    If you are not having symptoms then I would recommend waiting. I had one removed and it grew back.

  • chapman
    chapman Member Posts: 5

    Hi marie,

    Just read your message, curious why PASH can go away naturally? Would you mind tell more your condition of suffering PASH? let's say..

    Do you feel painful of it? Or what is your size of the PASH? or have you diagnosed with anyother breast related problems??

  • moderators
    moderators Posts: 7,884

    @chapman, marie5890's post was written in 2017, and the last time she was seen in the forums was in November 2022. It is possible that you may not receive a response from her. We suggest you send her a private message and see if she is still around. It's so easy! Just click on maries5890’s username to display her usercard, and then click the Message button to start a conversation with her.

    Hope this helps!

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  • chapman
    chapman Member Posts: 5

    Marie,

    Thank you for your reminder.

    By the way, Does anyone Pash go away naturally??? As i found most of cases which had to been taken away finally....

    Also Pash should not be painful, but sometimes i found you guys mentioned that it causes you discomfort. Does the feeling of discomfort last a day or a perit of time. Will you feel better in certain period??