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All TopicsForum: Benign Breast Conditions → Topic: Biopsy showed PASH

Topic: Biopsy showed PASH

Forum: Benign Breast Conditions —

A safe place to worry for members who have not been diagnosed with breast cancer, but have concerns about their breasts.

Posted on: Jul 8, 2017 10:54AM

mommakat wrote:

Hi Ladies,

Had a core biopsy last week and my radiologist had called and said it was b9 and see you in 6 months.

My GYN sent me a note and he full results and said there was a finding of PASH and I should follow up with a breast surgeon and possible excision.

I've been reading like crazy since of course and will call Monday morning for an appointment.

Anyone have experience with this? Did you just do lumpectomy or more aggressive treatment

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Jul 15, 2017 08:44AM - edited Jul 15, 2017 08:44AM by ElizabethDawn

Hey! I've been getting mammograms & yearly MRIs since I turned 30 due to family history of BRCA gene mutation. I had a mammo & biopsy done when I was pregnant 1.5 years ago & results came back as PASH. I have been going for mammograms every 6 months since & it's remaining stable with no growth. It's quite large (4 cm), but doctor says we'll just keep an eye on it & consider removal if/when it starts to grow.

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Jul 17, 2017 05:51AM mommakat wrote:

thanks Elizabeth! So they didn't take it out? And you have no symptoms right? My only real issue is my breast get extremely painful when I'm pms. Like have to wear sports bra excruciating pain. I've been reading that PASH is hormone related so I'm crooks if there's is any correlation. Amazing all of the new things I'm learning through This proc

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Jul 17, 2017 08:31PM ElizabethDawn wrote:

Not taking it out as of right now, but they're keeping a close eye on it. Going for another mammogram on Thurs so we'll see if there's been any change. My last two mammo's were done while I was still breastfeeding, but I stopped in Feb so hoping to get a better picture this time!

My breast gets sore with PMS too, but otherwise it doesn't bother me. I can feel the lump& move it around, but it doesn't hurt other than before my period.

Doc did say it's homone-driven, like u said, so she thought there may be a possibility it would shrink (best case) or grow (worst case) once I stopped nursing. Soooo we'll see!

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Jul 18, 2017 10:04AM mommakat wrote:

Good luck! Hope your mammo goes well!

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Jul 19, 2017 10:23PM Twilight11 wrote:

Hi your topic caught my attention because I too was told I have PASH. I was having bloody nipple discharge in one breast so they did an ultrasound and found a worrisome spot they thought for sure was cancer. Biopsy showed PASH though and they didn't seem too concerned. My insurance changed and it would be too expensive for a follow up though, and the bleeding seems to have stopped.

From what I have read they don't know if there is an increased risk for cancer for those of us with PASH. All seems vague to me though.

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Jul 20, 2017 05:45AM mommakat wrote:

it does seem a little vague twilight. And I think it's crazy that PASH has only been known since 1986. So much to learn. My doc felt that the surgeon might want to remove it. She said that although it isn't cancerous it can grown so rapidly that they do sometimes want to remove it. Who knows!? It's all mind boggling. I'm glad you're symptoms seemed to have improved. I'll keep you posted on what's theu say about it next month when I go for my follow up

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Jul 21, 2017 08:51PM Chemistry91 wrote:

I also have been diagnosed with PASH. My problems started in 2013 and it's been unnerving. I've had 3 biopsies and countless mammograms because I guess this looks like cancer on a mammogram. In 2015, I went to the main branch of the Cleveland Clinic and they have been helpful with treatment. My small town radiologist was not, no offense to them it's just very rare and they don't see it.

I have done quite a bit of research since I have a science background. Information however is limited because it is very rare.

It does appear to be progesterone driven and does not appear to be a precursor to cancer. One study I found states that woman with PASH are less likely to get cancer.

I recently had my mammogram and they are suggesting I get it removed as it has been progressing. I will meet with a breast surgeon next month.

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Jul 21, 2017 08:58PM mommakat wrote:

thanks chemistry ! It's a little bit of a mystery for sure. And I'm thankful that's it's all I have ( so far!) I'm interested to see what surgeon says. I think I'd love to have it removed and be done.

Good luck at your appointment. Keep meposted

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Aug 3, 2017 04:02PM Chemistry91 wrote:

I met with the breast surgeon today who said I needed to have it out. It has grown and is getting quite large. She said I will be noticeably different in size so she recommended meeting with the plastic surgeon so he could reduce the other side. Feeing afraid for the surgery but I know it needs to be done. I will have it removed and have a reduction on the other side.

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Aug 3, 2017 06:28PM mommakat wrote:

wow chemistry! I'm sorry to hear you have to have some prettty big surgery! Everything I read says that once they get it out it very rarely comes back. So hopefully it's one time and then no more breast issues! How big of an area is it? My appointment is finally only a week away! I can tell wait to just get there already! Are you able to schedule the surgery at a convenient time or is it like an asap thingg

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Aug 3, 2017 10:14PM Chemistry91 wrote:

it's gotten pretty big over the past 4 years. I believe it measures 7x2x3 cm. I am trying to schedule for November but since there are 2 doctors involved I have to work with their schedules. I teach so I wish I could have done this during the summer. Hope your appointment goes well!!! Keep us updated!

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Sep 12, 2017 11:46PM - edited Sep 30, 2017 07:21AM by Thunderstruck

I too have PASH. I had a mammogram in May that showed a 2.5 cm mass in my left breast. I had an ultrasound in June and was told by the radiologist that it was a fibroadenoma. I was given the choice to either have a biopsy or wait 6 months for another ultrasound to see if it was growing. I decided to see a breast surgeon for the biopsy. She did an Ultrasound-guided core needle biopsy in July. The samples she took showed PASH according to the pathology report. I decided to have it removed because I had been having pain in the same location as my mass, as well as my left arm, and left side of neck along with swelling above my collarbone. I had it removed in August. The breast surgeon did an excisional biopsy and used the "hidden scar" technique. That's where they cut around where the areola meets with the skin and tunnel towards the tumor. The pathology report showed PASH and atypical ductal hyperplasia. In total my surgeon removed 7x5x4 cm of tissue which included the mass and surrounding tissue. Incredibly, I don't see a size difference from having so much removed, which is approximately the size of a lime. My doctor wanted to be sure that the pathology results were correct because she said my results were so unusual and interesting, so she sent my samples to the Mayo Clinic. They agreed that it was PASH and atypical ductal hyperplasia. My breast surgeon gave me the option to see a medical oncologist to take an anti-estrogen medication, but said that there is no survival benefit should I get cancer, but it would decrease my risk for potentially developing cancer. I chose not to. She wants to see me every six months for breast exams and yearly mammograms.

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Sep 14, 2017 10:14AM mommakat wrote:

Thanks thunderstruck! So your PASH was causing some pain? I'm having alot of breast pain too, and I have my surgical biopsy next week. I didn't think to ask her to remove all of it, if it's indeed causing the pain. I guess I was waiting to make sure nothing was malignant.

can't wait until this over!

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Sep 20, 2017 10:05AM - edited Sep 20, 2017 10:09AM by Thunderstruck

Mommakat I forgot to mention that my PASH extended beyond the inked margins, but the ADH didn't. That's what's stated in my pathology report. When I see the breast surgeon again in 6 months I'll ask her if that means I still have PASH in there. My mass was in the left outer quadrant at 2 o'clock. I've been seeing a lymphadema physical therapist for the swelling and pain above my collarbone. It has helped tremendously with the pain. The swelling has also decreased. I'm also getting acupuncture on my left shoulder. I was desperate to get rid of this pain. I feel so much better now. Still have some pain in left breast where the mass was, but nowhere near what it had been before. I forgot to mention that I also had a cyst below the mass that was removed during my surgery.

From what I've read PASH cells are rare, but a PASH tumor is even rarer. I think what is left in me are PASH cells. I had the PASH tumor removed. I guess the surgeon didn't expect the PASH to extend past the margins of the tumor, but it did.

Let me know how your excisional biopsy turned out. I hope all goes well

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Sep 20, 2017 06:18PM mommakat wrote:

wow. You still have pain in that breast? That stinks.

I had my surgery this morning. I have no idea what kind of incision she ended up making. When I went for my consult she was 100% sure. It's in a tricky place of my double F boob, so she did know for sure. I think there is at least some periareola involved as I see some blood through the bandage there and my nipple felt like it was on fire afterwards. But really my whole bottom and outer half are bandages so I just am not sure. We'll see in 2 days.

I'm so curious about the pathology report and nervous. Have to wait until next Thursday.

So all in all it went well. Resting and taking pain meds. I can feel the throbbing and burning coming back as I get close to the next dose, so I figure, why suffer.

So your doc was ok with just watching your ADH too

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Sep 21, 2017 12:24AM Thunderstruck wrote:

I'm glad your surgery went well. Take it easy as much as possible. I'm sure your doctor told you no lifting anything over 10 lbs. I understand your nervousness about waiting for your results. I was given my pathology report at my follow-up appointment. I didn't read it until I got home, though my doctor did tell me what was on the report. If I had read it while still at my appointment I'd have asked a few more questions. I was just glad to hear that it was benign. Everything else paled in comparison. As for the ADH, the pathology report states that it didn't extend to the margins, so I'm assuming they got it all and it was only confined to the tumor. I had PASH and ADH mixed in with the tumor. I plan on asking my doctor at my 6 month check-up if the ADH and PASH are gone now.

Keep us informed of your results. I hope all turns out well and you heal quickly

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Sep 23, 2017 09:06PM Chemistry91 wrote:

Glad to hear you are both doing well! Keep us updated on the pathology.

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Sep 24, 2017 11:41AM - edited Dec 20, 2017 05:22PM by Thunderstruck

Hi Chemistry. I hope all turns out well for you, too. Keep us informed. I see you've been dealing with this for 4 years. My problem began in 2010...and I didn't even know it. I had a mammogram in 2010 and was told everything was fine. There was no report. In 2012 I had my next mammogram. I was told everything was fine, though report stated there was a density in my left breast. I thought it was referring to the fact that I have heterogeneously dense breasts, since doctors office called and said my mammogram was fine, come back in a year. I didn't go back for a mammogram until this year (2017). Mammogram showed 2.5 cm mass in left breast. It was then that I was told that the mass had been there since 2010 and hadn't grown or changed in size. I was shocked to learn that the mass was there since 2010. Had I known, I would not have skipped mammograms.

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Sep 24, 2017 07:47PM Chemistry91 wrote:

Thunderstruck...wow, crazy that they never stated that there was a mass present. My mammograms have always left my radiologists in a panic and I have been in the office for upwards of 3 hours while they were trying to figure out what to do with me. I wish I could find more online to read about PASH.

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Sep 27, 2017 09:57AM bew66 wrote:

Finally got the results of my biopsy from 14 days ago!  No papilloma, it's PASH!  Follow up in 6 months, Yay!!  I'm 57 years old, and I use HT for severe hot flashes, so I feel this diagnosis makes sense.

Best of luck to all you ladies still waiting for your results.  This forum is a great place for information.

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Sep 27, 2017 10:52AM - edited Sep 27, 2017 11:06AM by Grammy2be

Woo hoo bew66, great news!!

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Sep 27, 2017 11:23AM bew66 wrote:

Thank you Grammy2be!  I'm totally shocked at the diagnosis, but so relieved.  I do have to say, it really undermines my trust in doctors (which wasn't that strong to begin with).  The radiologist was so sure of her papilloma diagnosis, and there is, nor ever was, a papilloma.

Take care!

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Sep 28, 2017 03:14PM mommakat wrote:

well I got my excisional biopsy results. All behind again(phew!) but oddly, no pash noted this time. Follow up on 6 months. Wpphoo

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Sep 28, 2017 09:53PM Thunderstruck wrote:

That's great mommakat. Glad they didn't find anymore PASH.

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Sep 28, 2017 10:11PM Thunderstruck wrote:

Chemistry91, I hope you're doing as well as possible. I know the waiting can be difficult. It's scary when the radiologist is worried and doesn't know what to do with you. I hope your issue gets resolved soon. Here's a link you might find interesting. It's titled, "PASH: a clinical, radiologic and pathological study of 26 cases". http://www.nature.com/modpathol/journal/v21/n2/full/3801003a.html?foxtrotcallback=true

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Oct 16, 2017 08:00PM Chemistry91 wrote:

Thanks! Glad you got good results. Thanks for the article I will check it out.

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Oct 26, 2017 10:05AM Meewee wrote:

Thanks for the study info! A LARGE area of PASH was just discovered via my mammogram/sonogram. Had grown exponentially from the small area of density found in my mammo. two years previous. Neither the radiologist who read my results nor his 25-yr colleague who then did the subsequent biopsy had ever seen anything like it - 10cm in diameter, taking up roughly half the area of my left breast. Had a surgical consultation on Monday, and while the surgeon said the biopsy results were benign (a PASH often is), she recommended an MRI, which is scheduled for this coming Monday. She is hoping to NOT remove the area, since she said that PASH IS most often benign and she feels the removal of nearly 4" of my breast would be "too disfiguring", but she just wants to make SURE that the density of the PASH is not hiding any cancerous areas.

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Nov 9, 2017 05:36PM Shortygirl wrote:

Hi Ladies. I was first diagnosed with PASH in 2014. I also have fibrocystic breast disease. I had surgery to remove the mass that was found in 2014. The biopsy did not come back with clean margins so about 6 months later I had surgery again to remove all the PASH tissue. The margins were clean this time. Almost a year later I had developed some new cysts. A core biopsy revealed the PASH had returned also. I was referred to a breast specialist doctor expecting to have a mastectomy because my first doctor said that if anymore breast tissue was removed I would be left with deformity. Thankfully the breast specialist wasn't in as big a hurry to perform the mastectomy. I have been seeing her every 6 months. At the first of this year she found a new cyst and by the next appointment a defined mass had developed around the cyst so I had surgery again this August. I do have a slight sunk in place on the side of my breast, but it's not bad enough that I would prefer a mastectomy yet. I hate that you other ladies are having to deal with PASH also. There is so little information out there it is hard to educate yourself. I would like to share a few things I have found that helps with the pain. My pain is also worse around my cycle each month. My doctors have told me to take vitamin E twice daily. I take 400 IU. The breast specialist also told me to start taking Evening Primrose Oil. I take 1000 mg once daily. These supplements do seem to help. I have found caffeine to make it worse. I will not give up my large morning cup of coffee, but I limit it to that. I have recently tried using an essential oil because the pain had increased and it helped almost instantly!! I used Frankincense diluted with olive oil. I only use it at night cause it smells kind of strong, but it works. Meewee are they just going to monitor you mass for now?

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Nov 18, 2017 01:39PM Chemistry91 wrote:

My surgery is coming up here soon (11/27). Getting nervous.

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Dec 6, 2017 04:41PM Chemistry91 wrote:

Ladies I had my surgery on November 27th. I had a partial mastectomy on the left side and a reduction on the right. The pain hasn’t been to bad. I got my pathology today and it is PASH, with some other fibrous changes and microcysts. Meeting with the breast surgeon tomorrow to see how I will be monitored. The PASH tumor was able to be distinguished from the other breast tissue based on the pathology report.

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