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Topic: Living with 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: Dec 14, 2017 11:02AM

DailyZey wrote:

Hi - new to this forum and in desperate need of reassurance. I am 41 yrs old, no history of family breast cancer. Three months ago, I started experiencing tenderness in my left breast, especially right around ovulation time. Then it would go away and come back about a month later. I went to my obgyn and decided to do a diagnostic mammogram and an ultrasound. On Monday, I had the tests. The ultrasound showed a lump, high up on my chest wall, almost at my sternum. Doctor did a core needle biopsy, and we just got the results - it's diagnosed as PASH.

I have been reading everything I can, it looks like it's a benign, hormonal condition. Sometimes it can grow bigger, sometimes it can go away on its own. My question to this forum: 1) Have you been diagnosed with PASH? What was your experience?

2) Did you do anything to treat it? Or just monitor it?

3) Has it been painful? Is it always in the left breast? Seems to be predominantly left from what I read online. Also some report being in a lot of pain. Mine has just been tender for a few days so far but now I'm worried.

4) Any hormonal changes that can trigger it? Any suggestions or lifestyle changes you would recommend?

Thanks in advance for all the help.

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Dec 14, 2017 12:38PM marie5890 wrote:

Hi Daily,

Yep, my diagnosis was PASH. I chose not to do anything unless it became a problem or if it grew. My BS agreed with my choice , and it went away on it's own.

Mine was in my right breast.

What would I do if I was facing it again? Same thing. Monitor it. If it grew or if it started to cause problems (pain) then I would have it removed.

Dont be anxious. It's completely B9 :)

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.
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Dec 14, 2017 04:54PM Chemistry91 wrote:

I have PASH also and just recently had it removed. The location of your tumor is the EXACT location of mine. Interesting right? Mine always hurt more towards my cycle. I could feel the pressure from it growing. I have read that it is hormonal driven but they are unsure of the exact cause at this point. They are sure that it is benign however but it has a high density so it can interfere with your mammogram being read properly.

Mine had gotten significantly larger since 2013 and so it was time for it to be removed. It was biopsied 3 times so they were pretty confident in the diagnosis but due to its growth wanted it removed. While they were doing the wire localization the breast radiologist kept saying oh my gosh this is so big! Kind of freaked me out.

I had the tumor removed from my left and my right side reduced to match the size of my left breast. Hoping this works and it doesn’t come back. Won’t know for another year because they won’t mammogram me until next year.

Try not to worry but make sure you see a breast doctor that is familiar with PASH. It will give you peace of mind.

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Dec 14, 2017 09:49PM DailyZey wrote:


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Dec 15, 2017 03:20PM Shortygirl wrote:

1) Yes I have been diagnosed with PASH. Mine was already a palpable mass when I found it with self breast exam. I had seen OB for routine check a few months before and nothing was found then. Mine was obviously fast growing.

2) I had a core biopsy to determine diagnosis, then surgery to remove tissue, followed by two more surgeries as mine came back. I see a breast specialst every 6 months to monitor it.

3) Mine is the left breast also, but more towards my armpit. Mine has never been very painful. It has been mostly tender and achy. The most pain I have had was about a month or two after my last surgery but looking back I think the pain was from nerves healing because it only lasted a short while and has not been that way since. Outside of surgery pain, I have never hurt enough to need so much as even Tylenol for pain.

4) As far as hormones triggering it- it is hormone related but I don't know of anything we can do to change it. My doctor says as I get closer to menopause (I'm 39) it should start slowing down. She also said when I do start menopause that I will not be able to use hormone replacements to ease symptoms. I have noticed that caffeine has a definite impact on how tender I am, so I limit it a lot.

Chemistry- I'm glad you said you could feel it growing! I thought I could too and wondered if that really could be what I was feeling. It was a different sort of ache than normal fibro-cystic ache.

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Dec 20, 2017 06:03PM chispasgal wrote:

iam preparing for surgery for a 3cm pash lump .. I didnt even think to ask much at consult. After reading more i am worry. Surgeon said its very simple and id be good to go in 48 hrs.

Now i wonder if i need to have another consult?

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Dec 20, 2017 07:10PM marie5890 wrote:

What has you worried chis?

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.
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Dec 20, 2017 10:44PM chispasgal wrote:

marie5890- i guess just from reading other posts maybe i didn't ask enough questions(will size of tumor affect shape of breast, more about specifics of surgery etc. ) or havent educated myself enough on it(ignorance is bliss? Lol). I trust my surgeon but i suppose its all kinda sinking in now and just worry more if that makes sense?

Besides my 2 kids never really go to doc never had medical procedures so all this is new to me.

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Dec 23, 2017 12:59AM Susaine wrote:

No need to worry just follow this symptom, you will some lump like structure at your breast that is sign of chance.

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Jan 15, 2018 08:04PM 5spears wrote:

Chemistry91 I could have written this myself. Mine will be removed at the end of January with the other side being done at the same time!

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Jan 17, 2018 01:08AM Monique72 wrote:

I was just diagnosed with PASH today. The mass is about 1cm x 2cm, palpable, right-sided, near the nipple. It is painful near my period. I honestly think it’s always been there, but I don’t have a clear mental map of every lump in my breasts (there are many).

The hospital is recommending a six month follow up ultrasound. The mass was not visible in mammogram. I’m not keen on surgery, but I will discuss options with my primary care doc.

I was pretty much resigned to accepting a cancer diagnosis based on the ultrasound report. This is a relief, but it’s been a frustrating and stressful six weeks

Diagnosed with PASH tumor 1/16/2018
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Jan 17, 2018 08:58PM Chemistry91 wrote:

Good luck and keep us posted! I’m sure all will go fine. Let me know if you have any questions about recovery. You will be happy when it’s done

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Jan 17, 2018 10:00PM marie5890 wrote:


My Dx was PASH as well. From my perspective waiting 6 months is a very viable option because, like what happened with me, PASH can go away.

For some women, it grows. By waiting 6 months you may have a better idea of what your lesion will do, and then can make a decision. There is no hurry to make a decision with PASH. So, unless it really bothers you, as in painful, you may want to really consider waiting.

Just another perspective

Jan '11 Biopsy Dx-ed a PASH tumor (rare, but benign tumor)....All I ask is for peace and serenity to the depths of my soul. Makes the rest of life more live-able.
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Feb 8, 2018 03:26PM chispasgal wrote:

? for those who had surgery--- i had mine 2 weeks ago--1st week no pain at all--1 week after my breast is so sensitive to even clothes on it-and sore. At post op apt. my surgeon said to do moist heat and wear sports bra but so far that isn't helping antying either.... anyone go through this--I dont want to worry about it but its so uncomfy-more than the lump was :( Thanks!

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May 28, 2018 09:10PM Lacs93 wrote:

I have had Nodular PASH in both breasts since 2012 and I am now 46. I have been followed by Brigham ans Womens in Boston. It was a long process before they found a diagnosis, 3 hospital stays and 3 months of antibiotics. My breasts both grew from B to DDD left bigger than my right within a couple of weeks and it was unbelievably painful. I begged the specialist for a double mastectomy but she wanted me to try Tamoxifen. It controlled my symptoms but that is it. The one lump that was totally removed grew back. I stopped taking it in April of last year. In June they did a follow up mammo and ultrasound then sent me for a MRI. Again, everything was stable but all the lumps were still there. In July all the swelling and pain came back so fast that I got a 2nd opinion. For being a breast specialist she was totally clueless and recommended a breast reduction and she would remove the lumps then. They did a ultrasound and both breasts have multiple lumps, complex cysts among other benign diagnoses. That Dr ended up apologizing and recommended a total mastectomy as it would be impossible to remove all of them. I went back to Noston and restarted the Tamoxifen. My symptoms are back under control. My family life has been crazy since last July but I plan on going back to Boston in the next couple of months to see the new chief surgeon. Hopefully I can get her to do a study on me. The Specialist I have been seeing told me she rarely sees a case of one breast but has never seen it in both to my extreme.

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Jul 22, 2018 02:28PM KellJean wrote:

I have had PASH in both breasts for several years. I had tissue biopsies in both breasts and even sport some titanium tags now. I am a patient at the Cleveland Clinic Breast Pavilion and no one has ever suggested that I have a mastectomy. In fact, they aren't even doing tissue samples any more.

I had a complete hysterectomy 16 years ago and have been on a hormone patch since. Don't judge, please, I teach 6th grade and have to be clear-minded in front of 30 12 year olds. My breasts did get larger when I went on the hormones. Lately, they are very large and have areas of real pain. I see my breast specialist regularly which includes doctor exam, mammogram and ultrasounds.

My question is, can I do anything or add any supplement to my diet to minimize the pain and swelling? My doctor told me to take Oil of Evening Primrose. I didn't see a lot of improvement doing that.

Any advice would be welcome.


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Jul 22, 2018 08:48PM Lacs93 wrote:

I have been hoping someone would write with the similar situation as mine.

I am being followed by Brigham and Women's in Boston Massachusetts. The specialist I see has just retired and I will be seeing their new Head Surgeon in August. I have been on Tamoxifen since 2014 but that just is like a bandaid. I had stopped the Tamoxifen in April of last year and had a ultrasound and MRI which were both stable in June but in July all the symptoms returned in full force. The growth and pain was unbelievable. The sad part of it is that no one specializes in the severe cases and I feel like I know more about it now than the specialists do.I had to go back on the Tamoxifen. There is just not enough studies that have been done and a double mastectomy is my only alternative to Tamoxifen. I am trying to be hopeful that this new Head Surgeon will have more experience and some advice.

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Jul 31, 2018 07:36PM Chemistry91 wrote:

I have heard that Iodine helps? Is your PASH growing? I know I could physically feel mine getting larger and it was painful.!

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Jul 31, 2018 07:39PM Chemistry91 wrote:

PASH can be extremely frustrating because it is so rare in tumor form and not many doctors are familiar with it. I would not hesitate to get a second opinion regarding removal and treatment. Is it wide spread throughout your breasts and that’s why they would only remove via a mastectomy?

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Jul 31, 2018 08:40PM Lacs93 wrote:

When I stopped the Tamoxifen last yeara everything came back fast and worse than before. I went to see my Specialist in Boston and was sent home with no help whatsoever. I was given the run around and was told she would consult with her colleagues and would get a call before she went on a 2 week vacation. I did not receive that call so I went to get a second opinion with a Breast Surgeon who stated she had experience. When I saw her I brought records with me. I realized after talking with her she did not review my records and that I knew more about my condition than she did. She, as a Breast Specialist, recommended lumpectomies and bilateral Breast reduction. (My last lumpectomy grew back and studies have shown that after a reduction the breast will continue to grow depending on severity). She ended up ordering Ultrasound. Again I felt they were less educated than me as the Tech repeatedly told me I just had fibroadenomas (which I was misdiagnosed in 2012 with). My ultrasound showed severe bilateral density, massive complex cysts throughout both breasts, along with several other abnormalities. When she returned to the room she apologized stating there were too many tumors/complex cysts too count and my only option would be a total bilateral mastectomy. Needless to say I have literally been through hell with this as there are are really no studies, nor enough knowledge in regards to the severity of my case. My Specialist at Brigham and Women's has never seen Tumorous Bilateral PASH The only thing she recommended (and her colleagues) was to continue with Tamoxifen. I will be seeing the new Chief of Surgeons in Boston August 15th and I am trying to be hopeful but it is hard. Any advise would be GREATLY appreciated at this point!!!!

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Aug 1, 2018 08:45AM Chemistry91 wrote:

Lace93...I am so sorry for what you are going through and know how frustrating PASH can be. I am hoping your appointment on August 15th gives you some better options.

The Cleveland Clinic does have an online program where you can chose a radiologist and they will review your images and provide you with a second opinion. I have found them to be competent and they are familiar with PASH as well. I think it costs around 300 dolllars, but it might be worth it to see what they have to say.

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Nov 25, 2018 10:02PM Lacs93 wrote:

I went to see the new Chief Surgeon at Brigham and Women's in Boston back in August and she has only seen 1 other person who has had the same severity as mine. That patient had to have a breast reduction twice. She was not a candidate for Tamoxifen as she was trying to get pregnant. Prior to seeing this surgeon I was having new health issues, most important was that I had 3 TIA's and no one could figure out why. One of the first things I told the surgeon was that. She told me I had to stop the Tamoxifen immediately as that was one of the side effects to long term use. All the symptoms are returning but not as rapidly as before. Of note, in 3 days I will 3 weeks s/p a complete hysterectomy. I am now on a HRT patch but have been decreasing the dosage every week to see how and/or if my breast symptoms go away. My only other option is a double mastectomy. I am just hoping it doesn't come down to that.

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Dec 2, 2018 09:43PM Abby99 wrote:

just so you know you are not alone.....I have bilateral pash all over breasts. I have had 3 surgeries and it all grows back within 6 months. Inhave had at least 10 removed with approx 7-8 more now. I jus monitor as all surgeons I have seen think mastectomy is extreme for now. If you have questions, pls ask!
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Dec 2, 2018 09:51PM Lacs93 wrote:

Abby99, Did you or are you taking Tamoxifen?

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Dec 3, 2018 05:52AM Chemistry91 wrote:

I have my one year check up for having my PASH removed next week. I am so worried it has come back, as I don’t know what the next course of treatment will be.

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Dec 3, 2018 09:40AM Lacs93 wrote:

If it's been a year and you have had no problems then that is good!!!

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Dec 14, 2018 03:51PM DailyZey wrote:

Hi all - wanted to do an update on my own PASH symptoms. It's been 1 year since I was initially diagnosed. I've had six month checkups since then. I just had my check up and I'm happy to report that my PASH cyst in my left breast is unchanged in size. No other cysts have shown up. I still have overall tenderness - quite a lot of tenderness if I drink any caffeine actually. But I stopped coffee and just went to herbal and low-caffeine teas and it seems to help a bit. In general, I'm just happy that nothing's changed or gotten worse!

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Dec 15, 2018 09:58PM Chemistry91 wrote:

I had my one year check up since my surgery last year and all was well! I was so nervous because I have had some pain in the breast where the PASH was removed. Hopefully it continues to stay away.

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Dec 15, 2018 10:23PM Lacs93 wrote:

I am now 5 weeks s/p a complete hysterectomy. I was put on a HRT patch but was cutting it in half every week when I would put a new one on. This past Wednesday I stopped the patch altogether. The bilateral multiple Tumorous lumps and swelling have all been subsiding. Not completely gone but feel confident that within a couple months there will be no more pain, swelling or lumps and bumps! The direction this is going could be the proof that the Dr's needed the it IS driven by hormones and not "maybe".

As nonsymptomatic PASH is relatively common, Bilateral, Tumorous PASH is not. With the bilateral pain, swelling and massive amount of PASH tumors and complex cysts I can say these symptoms were/are life altering. I am keeping my fingers crossed all of this will become a part of my past.

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